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Approximately 18,000 cases of colorectal cancer (CRC), accounting for 12.3% of all cancer types, were diagnosed in Korea during 2005. Approximately 20% of these patients were found to have metastatic CRC (mCRC), which has a 5-year survival rate of 10%, at the initial diagnosis. Oxaliplatin- and irinotecan-based combination chemotherapy with infusional 5-FU and leucovorin are currently the standard first-line therapies for mCRC. Recent studies have suggested, however, that survival outcomes can be further improved by adding biologic agents such as cetuximab and bevacizumab to the chemotherapy regimen. Novel treatment strategies involving the increasing number of therapeutic agents are being investigated to improve the efficacy, safety, and tolerability of multi- agent therapy. These strategies have included switching the therapy before progression, maintenance therapy, and chemotherapy- free intervals. Studies have found that the effectiveness of targeted therapies can be linked to the presence or absence of specific genomic changes. Consequently, identifying patients who are amenable to targeted therapy will be essential in daily practice as well as in clinical trials. In the present work, we review recent innovations in chemotherapy for mCRC with a focus on emerging data that may significantly improve both the survival and quality of life for patients with CRC. (Korean J Med 77:18-25, 2009) |
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