Review article

Systemic therapy for colorectal cancer – Overview of recent trials

Jasna Radić
Željko Soldić
Jasmina Marić Brozić
Davor Kust
Ante Bolanča
Zvonko Kusić

Abstract

Colorectal cancer (CRC) is the most common malignancy of the gastrointestinal tract worldwide, and also one of the leading causes of cancer-related mortality, accounting for more than 600000 deaths every year. Depending on the stage of the disease some patients who were surgically treated for CRC with curative intent require adjuvant chemotherapy (fluorouracile-based), which reduces the risk of recurrence and death in patients with stage III CRC, but its role in stage II is still controversial. Pathogenesis of CRC is a result of two different genetic pathways: chromosomal instability (CIN), and inactivation of mismatch repair (MMR) genes. Stage II patients with deficient MMR tumor status do not benefit from adjuvant therapy and should receive surgery alone. For patients with metastatic CRC optimal sequence of chemotherapy regimens and targeted therapy is still debated. Epidermal growth factor receptor (EGFR) has been validated as a therapeutic target in several human tumors including CRC. Recently it has been reported that activating mutations in exons 2, 3, and 4 of both KRAS and NRAS all predict a lack of response to EGFR trageted agents. Recent studies suggest BRAF is another prognostic and potential predictive biomarker of CRC. It is necessary to indentify new prognostic and predictive markers, to acquire maximal benefit from every therapy line and to improve prognosis of these patients.

Keywords

colorectal cancer; personalized medicine; chemotherapy; targeted therapy; biomarkers

Hrčak ID:

139045

URI

https://hrcak.srce.hr/139045

Publication date:

14.5.2015.

Article data in other languages: croatian

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