Novel therapeutics in metastatic colorectal cancer: molecular insights and pharmacogenomic implications

Expert Rev Clin Pharmacol. 2016 Aug;9(8):1091-108. doi: 10.1586/17512433.2016.1172961. Epub 2016 Apr 14.

Abstract

Although the survival of metastatic colorectal cancer (mCRC) patients has improved five-fold over the last century, CRC remains a significant global health burden. Impressive strides have been made in identifying new regimens, employing maintenance strategies to limit treatment toxicities, and combining multidisciplinary approaches to achieve cure in oligometastatic disease. Attempts at personalized integration of targeted agents have been limited by the ability to identify molecularly enriched patient populations most likely to benefit. In this review, we discuss novel therapeutics and regimens recently approved and in development for mCRC. In addition, we discuss using older agents in novel combination and maintenance strategies, and highlight evidence for implementing pharmacogenomic data and non-invasive monitoring into the personalized management of mCRC patients.

Keywords: Angiogenesis; EGFR; RAF; RAS; biomarker; fluoropyrimidines; immunotherapy; metastatic colorectal cancer; microsatellite instability; pharmacogenetics.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology
  • Drug Design
  • Humans
  • Molecular Targeted Therapy
  • Neoplasm Metastasis
  • Pharmacogenetics*
  • Precision Medicine / methods
  • Survival Rate

Substances

  • Antineoplastic Agents