Treatment Options in Late-Line Colorectal Cancer: Lessons Learned from Recent Randomized Studies

Systemic treatment of metastatic colorectal cancer (mCRC) has improved considerably over the past 20 years. First- and second-line combinations of 5FU, oxaliplatin, and irinotecan, with or without anti-angiogenic and/or anti-EGFR antibodies, were approved shortly after the turn of the millennium. Fu...

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Bibliographic Details
Published in:Cancers 2023-12, Vol.16 (1), p.126
Main Authors: Tarpgaard, Line Schmidt, Winther, Stine Brændegaard, Pfeiffer, Per
Format: Article
Language:English
Subjects:
Angiogenesis
Antimitotic agents
Antineoplastic agents
Cancer
Cancer therapies
Care and treatment
Chemotherapy
Clinical trials
Colorectal cancer
Colorectal carcinoma
ErbB-2 protein
FDA approval
Gene mutations
Genetic aspects
Irinotecan
Kinases
Metastases
Metastasis
Monoclonal antibodies
Mutation
Oncology
Oncology, Experimental
Oxaliplatin
Patients
Quality of life
Review
Trifluridine
Tumors
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Summary:Systemic treatment of metastatic colorectal cancer (mCRC) has improved considerably over the past 20 years. First- and second-line combinations of 5FU, oxaliplatin, and irinotecan, with or without anti-angiogenic and/or anti-EGFR antibodies, were approved shortly after the turn of the millennium. Further triumphs were not seen for almost 10 years, until the approval of initially regorafenib and shortly after trifluridine/tipiracil. A growing understanding of tumor biology through molecular profiling has led to further treatment options. Here, we review the most recent clinical data for late-line treatment options in mCRC, focusing on randomized trials if available. We include recommendations for options in unselected patients and therapies that should only be offered in patients with distinct tumor profiles (e.g., BRAF mutations, KRAS G12C mutations, HER2 amplification, deficient MMR, or NTRK gene fusions).
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers16010126