Targeted Therapies in the Treatment of Colorectal Cancers
Authors: Todd Alekshun, MD, Chris Garrett, MD
Abstract
Background: In solid organ malignancies, no tumor type has seen a greater impact from the development of novel targeted therapies in 2004 than metastatic colorectal cancer.
Methods: We review the current progress to date with the use of monoclonal antibodies in colorectal cancer and look at newer therapies under investigation.
Results: Two monoclonal antibodies received Food and Drug Administration approval in early 2004, both for the indication of advanced, metastatic colorectal cancer. A large, randomized, placebo-controlled study demonstrated that the addition of a monoclonal antibody to vascular endothelial growth factor, bevacizumab, led to a statistically significant improvement in overall survival, with tolerable additional toxicity. Chimeric monoclonal antibody therapy directed at the epidermal growth factor receptor was associated with radiographic responses in a significant minority of patients with irinotecan-refractory colon cancer in a randomized phase II study of patients with irinote-can-refractory disease.
Conclusions: These dramatic successes have led to further clinical studies of targeted therapy in colorectal cancer, making it one of the most promising areas of cancer research.
Background
The relationships between growth factors, cell surface receptors, and their second messengers in the development and progression of human malignancies are not new concepts. However, recent advances in molecular and cell biology techniques have allowed for rapid advances in rational drug design and targeted therapies for the treatment of human malignancies. Among the most recent advances in treatments for colorectal cancer are therapies that target novel cellular entities such as EGFR and VEGF (Figure 1). The uses of therapeutic targeting of these molecular structures in colorectal cancer are enhancing the treatment of colorectal cancer. This review summarizes targeted therapies for treating colorectal cancer.
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