Chemotherapy Advances for Stage IV CRC

This year has brought to us the completion of several clinical trials evaluating new agents for Stage IV colorectal cancer.

BEVACIZUMAB (AVASTIN)

Bevacizumab (Avastin) is a humanized monoclonal anbtibody directed against vascular endothelial growth factor. It was studied in a trial of 813 patients with Stage IV colorectal cancer using the standard regimen of irinotecan, 5-FU, and leucovorin as a control. The control group had a median survival of 15.6 months while the study group had a median survival of 20.3 months.

CETUXIMAB (ERBITUX)

Cetuximab (Erbitux) is a humanized monoclonal antibody directed against epidermal growth factor receptor. It was recently studied on patients who had progressed while on irinotecan-based therapy and found a median 8.6 month survival on this group of patients. There is currently no accepted treatment in patients who have failed standard therapy in Stage IV color so this represents an important advance.

The role of these agents in adjuvant treatment of Stage II and III colorectal cancers as well as in the neoadjuvant setting will be the next phases of study and should be quite interesting.