Chemotherapy and Biological Treatment in the Complex Management of Large Intestinal and Rectal Carcinomas. When, Why, How?
Authors:
E. Kubala; L. Petruželka; E. Sedláčková
Authors‘ workplace:
Onkologická klinika VFN a UK 1. LF, Praha, přednosta: prof. MUDr. L. Petruželka, CSc.
Published in:
Rozhl. Chir., 2009, roč. 88, č. 6, s. 303-307.
Category:
Monothematic special - Original
Overview
The colorectal cancer treatment has significantly changed in last few years. Use of new drugs such as oxaliplatin, irinotecan, or capecitabine improved long term survival of patient with this disease. Research of biologic and genetic behavior of CRC has brought new ways in therapy called „biologic therapy”.
Standard today’s treatment consist of three drugs:
bevacizumab (antiVEGF antibody), cetuximab and panitumimab (anti EGFR antibodies).
Biology therapy should be used simultaneously with chemotherapy only and after genetic examination of the cancer (K ras mutation). For patients with stage III the adjuvant therapy with combination of FOLFOX (oxaliplatin, fluorouracil, and leukovorin) is recommended to reduce the probability of recurrence and improve survival. In stage IIB there is a clear need to determine further risks which classify the high risk patients who should be enrolled in adjuvant chemotherapy.
In palliative treatment of colorectal cancer there are several chemotherapy combinations (FUFA, FOLFOX, FOLFIRI, XELOX, XELIRI) used with biologic therapy. International recommendation for the biologic therapy is in the first line treatment bevacizumab and cetuximab or panitumumab in the second line is recommended.
The new discoveries in biology of colorectal cancer show the need of tailoring.
Key words:
adjuvant therapy – palliative therapy – biological therapy – genetic examination
Sources
1. Le Foyer,T. E., et al. INT - 089. J. Clin. Oncol., 2003, 21, s. 2912–2919.
2. O’Connel, et al. Surveillance, Epidemiology and Results registry J. Natl. Cancer Indy., 2004, 96, s. 1420–1425.
3. International Multicentre Pooled Analysis of Colon Cancer Trial (IMPACT) Investigators: Efficacy of adjuvant fluorouracil and folinic acid in colon cancer. Lancet 345, 1995, s. 939–944.
4. Mamounas, E., Weinard, S., Walmark, N., et al. Comparative efficacy of adjuvant chemotherapy in patiens with Dukes’B versus Dukes’C colon cancer: Results from national surgical adjuvant brest and bowel project adjuvant studies (C-01, C-02, C-03, and C-04). J. Clin. Oncol., 1999, 17, s. 1349–1355.
5. Andre, T., Boni, C., Mounedji-Boudiaf, L., et al. Oxaliplatin, fluorouracil and leucovorin as adjuvant treatment for colon cancer. N. Engl. J. Med., 2004, 350, s. 2343–2351.
6. Cassidy, J., Scheithauer, W., McKendrick, J., et al. Capecitabine (X) vs bolus 5-FU/leucovorin (LV) as adjuvant therapy for colon cancer (the X-ACT study): positive efficacy results of phase III trial. Proc. Am. Soc. Clin. Oncol., 2004, 23, s. 2475, (abstr 3509).
7. Nordlinger, H., Skrbte, L., Collette, B., et al. Final results of the EORTC Intergroup randomized phase III study 40983 (EPOC) evaluating the benefit of perioperative FOLFOX 4 Chemotherapy for patiens with potentially resectable cororectal cancer liver metastases. J. Clin. Oncol., 2007; ASCO Annual Meeting Proceedings (Post-Meeting Edition), 25, 18S (June 20 Supplement), 2007; abstract LBA5.
8. De Gramont, A., Cervantes, A., Andre, T., et al. OPTIMOX study: FOLFOX 7/LV5FU2 compared to FOLFOX 4 in patiens with advanced colorectal cancer. J. Clin. Oncol., 2004, 22, s. 251, (suppl; abstr 3525).
9. Saltz, L. B., Cox, J. V., Blanke, C., et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. N. Engl. J. Med., 2000, 343, s. 905–914.
10. Tournigand, C., Andre, T., Achille, E., et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advaced colorectal cancer: A Randomized GERCOR study. J. Clin. Oncol., 2004, 2, s. 229–237.
11. Ferrana, N., Hillan, K. J., Gerber, H. P., et al. Dicsovery and development of bevacizumab, an anti-VEGF antipody for treating cancer. Nat. Rev. Drug Discov., 2004, 350, s. 2335–2342.
12. Kiss, I., Tomášek, J., Halámková, J. Biologická léčba kolorektálního karcinomu. Remedia, 2008, 18, s. 28–34.
13. Hurwitz, H., Fehrenbacher, I., et al. Bevacizumab plus Irinotecan, Fluorourail and Leucovorin for Metastatic Coleorectal Cancer. N. Engl. J. Med., 2004, 350, s. 2335–2342 (study 2107).
14. Hecht, J., Chidiac, T., Mitchell, E., et al. An interim analysis of efficacy and safety from randomized controlled trial of panitumumab with chemotherapy plus bevacizumab for metastatic colorectal cancer. Ann. Oncol., 2007, 18, vii 21, abstact 0–0033.
15. Giantonio, B. J., Catalano, P. J., et al. Bevacizumab in combination with oxaliplatin fluorouracil and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer; results from ECOG study E3200. J. Clin. Oncol., 2007, 25, s. 1539–1544.
16. Grothey, A., et al. Beacizumab beyone first progression is associated with prolonged overall survival in metastatic colorectal cancer: results from large observatinnal kohort study (BRiTE). J. Clin. Oncol., doi: 10.1200/JCO 2008, 16.3212.
17. van Cutsen, E., Nordinger, B., Adam, R., et al. Towards a pan-European konsensus on the treatment of patients with colorectal liver metastase: Eur. J. Cancer 2006, 42, s. 2212–2221.
18. Zorzi, D., Kishi, Z., Maru, D. M., et al. Effect of extended preoperative chemotherapy on pathologic response and postoperative liver insufficiency after hepatic resection for colorectal liver metastase. ASCO GIT Cancer Symposium 2009, abstrakt 295, s. 207.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2009 Issue 6
Most read in this issue
- Endoscopic Diagnostics and Treatment of Flat Intestinal Lesions
- Chemotherapy and Biological Treatment in the Complex Management of Large Intestinal and Rectal Carcinomas. When, Why, How?
- Antibiotic Prophylaxis in Colorectal Surgery
- Enteral Fistula as a Postoperative Complication – A Case Report