RT Journal Article
T1 Current Options for Third-line and Beyond Treatment of Metastatic Colorectal Cancer. Spanish TTD Group Expert Opinion.
A1 Fernandez-Montes, Ana
A1 Gravalos, Cristina
A1 Pericay, Carles
A1 Safont, Ma Jose
A1 Benavides, Manuel
A1 Elez, Elena
A1 Garcia-Alfonso, Pilar
A1 Garcia-Paredes, Beatriz
A1 Carrato, Alfredo
A1 Aranda, Enrique
K1 Biomarkers
K1 Colorectal neoplasms
K1 Mutations
K1 Refractory
K1 Therapy
AB Colorectal cancer (CRC) is a public health problem: it is the third most common cancer in men (746,000 new cases/year) and the second in women (614,000 new cases/year), representing the second leading cause of death by cancer worldwide. The survival of patients with metastatic CRC (mCRC) has increased prominently in recent years, reaching a median of 25 to 30 months. A growing number of patients with mCRC are candidates to receive a treatment in third line or beyond, although the optimal drug regimen and sequence are still unknown. In this situation of refractoriness, there are several alternatives: (1) To administer sequentially the 2 oral drugs approved in this indication: trifluridine/tipiracil and regorafenib, which have shown a statistically significant benefit in progression-free survival and overall survival with a different toxicity profile. (2) To administer cetuximab or panitumumab in treatment-naive patients with RAS wild type, which is increasingly rare because these drugs are usually indicated in first- or second-line. (3) To reuse drugs already administered that were discontinued owing to toxicity or progression (oxaliplatin, irinotecan, fluoropyrimidine, antiangiogenics, anti-epidermal growth factor receptor [if RAS wild-type]). High-quality evidence is limited, but this strategy is often used in routine clinical practice in the absence of alternative therapies especially in patients with good performance status. (4) To use specific treatments for very selected populations, such as trastuzumab/lapatinib in mCRC human epidermal growth factor receptor 2-positive, immunotherapy in microsatellite instability, intrahepatic therapies in limited disease or primarily located in the liver, although the main recommendation is to include patients in clinical trials.
PB Elsevier
YR 2020
FD 2020-04-13
LK http://hdl.handle.net/10668/15695
UL http://hdl.handle.net/10668/15695
LA en
NO Fernández-Montes A, Grávalos C, Pericay C, Safont MJ, Benavides M, Élez E, et al. Current Options for Third-line and Beyond Treatment of Metastatic Colorectal Cancer. Spanish TTD Group Expert Opinion. Clin Colorectal Cancer. 2020 Sep;19(3):165-177
DS RISalud
RD Apr 8, 2025