Targeted agents to improve treatment results in colon cancer: Bevacizumab and cetuximab

Baruch Klein*, Maya Gottfried

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

The addition of bevacizumab (BEV) and cetuximab to chemotherapy in the treatment of metastatic colorectal cancer (MCRC) has resulted in an increase of progression-free survival (PFS) and overall survival. BE Vis usually given in thefirst line setting and can be combined with any chemotherapeutic regimen. BEV has activity also in the second line setting but not in the thirdline. Ithas beenproven to be safe in the community setting (BRiTE) and in thepost-marketing study (BEAT), and confirmed its efficacy and safety in the first line with all regimens of themotherapy. In addition, retrospective analyses demonstrate that surgery with curative intent can be performed in about 20% of the patients on BEV. Cetuximab has activity and prolongs survival in third line and above setting as observed in the NCIC study and PFS in the BOND study in patients failing irinotecan-based chemotherapy. Cetuximab increases PFS in the second line setting, as seen in the EPIC study. In the first line setting (CRYSTAL study), cetuximab increased PFS Moreover the percentage of patients undergoing curative resection for colorectal cancer is tripled. Skin toxicity is related to survival. In patients not having skin toxicity, dose escalation (EVERESTstudy) increased skin toxicity and response rate. Combination of biologicals is feasible (BOND-2), but financial considerations constitute aproblem. BEV is approved for first and second line treatments, and cetuximab is approved inpatients failing irinotecan.

Original languageEnglish
Pages (from-to)S127-S136
JournalJournal of B.U.ON.
Volume12
Issue numberSUPPL. 1
StatePublished - Sep 2007
Externally publishedYes

Keywords

  • Bevacizumab
  • Cetuximab
  • FOLFIRI
  • FOLFOX
  • Metastatic colorectal cancer
  • Progression free survival

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