Potentially resectable metastatic colorectal cancer: An individualized approach to conversion therapy

Donatella Marino, Francesco Leone, Francesca D'Avanzo, Dario Ribero, Lorenzo Capussotti, Massimo Aglietta

Research output: Contribution to journalArticlepeer-review

Abstract

In recent years, the survival of patients with metastatic disease has improved due to the developments in both medical and surgical care. Patients with technically unresectable metastatic disease could benefit from a multidisciplinary approach for their possible shift toward a technically resectable condition; the choice of the most effective systemic treatment is then crucial to allow conversion to resectability. Systemic conversion therapy may include chemotherapy agents' combinations (fluoropyrimidine, irinotecan and oxaliplatin), with or without targeted agents (cetuximab, panitumumab, bevacizumab). The choice of the best treatment option has to be evaluated by taking into account each patient's baseline characteristics, biological and pathological information and surgical strategy. In particular, the role of some biologic characteristics of the disease, namely the mutational status of EGFR-pathway oncogenes, is emerging as an important predictive factor of response to anti-EGFR targeted agents. Patients presenting with colorectal cancer metastases should be evaluated for multimodal management with curative intent as the appropriate chemotherapy regimen may induce tumor shrinkage, conversion to resectability and improved survival.

Original languageEnglish
Pages (from-to)218-226
Number of pages9
JournalCritical Reviews in Oncology/Hematology
Volume92
Issue number3
DOIs
Publication statusPublished - Dec 1 2014

Keywords

  • Chemotherapy
  • Colorectal cancer
  • Colorectal cancer metastases
  • Conversion therapy
  • Metastasectomy
  • Resection
  • Targeted therapies

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Geriatrics and Gerontology
  • Medicine(all)

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