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  • Title: Review article: current management of metastatic colorectal cancer - the evolving impact of targeted drug therapies.
    Author: Yau T, Chan P, Ching Chan Y, Wong BC, Liang R, Epstein RJ.
    Journal: Aliment Pharmacol Ther; 2008 Jun 01; 27(11):997-1005. PubMed ID: 18363897.
    Abstract:
    BACKGROUND: The field of colorectal cancer chemotherapy has been transformed by the advent of molecule-specific drugs. Combined use of such drugs enhances tumour response rates, but controlled data quantifying the relative efficacy and cost-effectiveness of different drug combinations on overall survival remain scarce. AIM: To conduct an overview of published clinical trials in advanced colorectal cancer, with the objective of framing provisional approaches to current management. METHODS: An NCBI/PubMed search was performed using the strings, 'colorectal cancer' ('metastatic' or 'advanced' or 'palliative') and ('chemotherapy' or 'drug therapy' or 'targeted' or 'target-specific' or 'molecularly-targeted'). RESULTS: Combinations of target-specific drugs (with or without the DNA-alkylating agent oxaliplatin) have substantially enhanced colorectal cancer time to progression over the last decade and have also expedited surgical resection of liver metastases. Disease-free survival, overall survival and quality of life are favourably influenced. CONCLUSIONS: Target-specific drugs improve palliative efficacy in the setting of advanced colorectal cancer. However, key issues persist as to the cost-effectiveness of these newer drug treatments, and further controlled trials are needed to resolve this important debate.
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