Critical evaluation of current treatments in metastatic colorectal cancer
Critical evaluation of current treatments in metastatic colorectal cancer
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DOI：
10.1634/theoncologist.10-4-250
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发表时间：
2005-04-01
期刊：
影响因子：
5.8
通讯作者：
Venook, A
中科院分区：
文献类型：
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作者：
Venook, A
多年来，氟尿嘧啶(FU)一直是转移性结直肠癌(MCRC)的主要治疗方案。然而，近年来，较新的化疗药物，特别是伊立替康(Campostar(R)；辉瑞制药，纽约，NY，http://www.prizer.com)和最近的奥沙利铂(Eloxatin(R)；赛诺菲-安万特公司，纽约，NY，http://www.sanori-aventis.com)，)已被证明与以FU为基础的疗法相结合可以提高生存率。因此，这些药物被纳入一线和二线治疗策略。靶向药物的开发具有肿瘤特异性，比化疗药物具有更好的毒性特征，拓宽了这种疾病的治疗范围。美国食品和药物管理局(FDA)最近批准了两种用于治疗结直肠癌的靶向药物：抗血管内皮生长因子单抗(BEVA-CIZUMAb)(阿瓦斯丁；加利福尼亚州旧金山南部的Genentech，Inc.，http://www.gene.com)，)与一线基于5-FU的化疗方案和人表皮生长因子受体(HER-1/EGFR)靶向性单抗西妥昔单抗(Erbitux(R)；ImClone Systems，Inc.，New York，NY，http://www.imclone.com)作为难治性癌症的单一疗法或与伊立替康联合作为二线疗法。这些新的、更有效的药物正在改善mCRC患者的临床结果。然而，随着药物数量的增加，选择最有效的治疗策略变得越来越复杂。这篇综述讨论了单个药物在治疗多发性结直肠癌中的作用，并确定了最有效的方案。
Fluorouracil (FU) has been the mainstay of treatment for metastatic colorectal cancer (mCRC) for many years. However, in recent years, newer chemotherapeutic agents, particularly irinotecan (Campostar (R); Pfizer Pharmaceuticals, New York, NY, http://www.prizer.com) and more recently oxaliplatin (Eloxatin (R); Sanofi-Aventis Inc., New York, NY, http://www.sanori-aventis.com), have been shown to improve survival in combination with FU-based therapies. These agents were therefore incorporated into first- and second-line treatment strategies. The development of targeted agents that are tumor specific with better toxicity profiles than chemotherapeutic agents has widened the spectrum of therapies for this disease. The U.S. Food and Drug Administration (FDA) recently approved two targeted agents for treating mCRC: an antivascular endothelial growth factor monoclonal antibody (mAb), beva-cizumab (Avastin (R); Genentech, Inc., South San Francisco, CA, http://www.gene.com), in combination with first-line 5-FU-based chemotherapy regimens and the human epidermal growth factor receptor (HER-1/ EGFR)-targeted mAb cetuximab (Erbitux (R); ImClone Systems, Inc., New York, NY, http://www.imclone.com) as monotherapy or in combination with irinotecan as second-line therapy in refractory cancer. These newer, more effective agents are improving clinical outcome for patients with mCRC. However, as the number of agents has increased, choosing the most effective treatment strategy has become increasingly complex. This review discusses the role of the individual agents in the treatment of mCRC and identifies the most effective regimens.