Treatment of Colorectal Cancer News

Just last year, held in June of Clinical Oncology American Medical Association Council meeting in a discussion like the treatment of colorectal cancer event, from the stages of disease, early colorectal cancer postoperative adjuvant chemotherapy treatment of metastatic colorectal cancer treatment have a wonderful report and the results of these studies may change our future for colorectal cancer treatment modalities. 
Because the United States for chemotherapy of colorectal cancer varies with Taiwan, this article only introduce several important results and personal opinion. At present, commonly used in colorectal cancer drugs, including 5-FU, Leucovorin (LV), Irinotican and oxaliplatin four, at this meeting in a well-known French scholar deGramont report of a response to the second and third period in patients with colorectal cancer postoperative adjuvant chemotherapy of clinical trial (MOSAIC trial) results and found that the oxaliplatin plus 5-FU and LV alone than 5-FU and LV is better, if the results of the United States for another large-scale clinical NSABP C07 trial confirmed, perhaps the future should be the use of oxaliplatin in colorectal cancer postoperative adjuvant chemotherapy. 

Another study (N9741) is more 5-FU + LV + Oxaliplatin (FOLFOX4), 5-FU + LV + Irinotican (IFL), and Irinotican + Oxaliplatin (IROX) three methods of treatment of metastatic colorectal cancer of the efficacy and Living quality, results showed that FOLFOX4 best, and the IFL and IROX in a par between the three aspects of quality of life almost. FOLFOX4 treatment showed N9741 remission rate of up to 40%, while the IFL and IROX 30%, with a median survival of 19.1 months, respectively, three, 14.8 months and 17.0 months. The results showed that FOLFOX4 in metastatic colorectal cancer in first-line treatment is a good choice. However, the study of this group in the IFL used 5-FU + LV injection and more commonly used in Taiwan is different if its conversion to injection of FOLFOX4 or FOLFOX6 injection (which can be referred to as FOLFIRI) may be different results. 

Another clinical trial (EFC4584) confirmed that patients in the IFL after treatment failure, FOLFOX4 than the separate use of oxaliplatin or 5-FU + LV effects better, FOLFOX4 may improve remission rates and improve symptoms, but it was not clear The median survival period of patients was not significantly prolonged. However, due to the FOLFOX4 very obvious improvement in symptoms, it should recommend the use of FOLFOX4. 

In this meeting with two other monoclonal antibodies used in chemotherapy also have a good score, the first study was aimed to Irinotican treatment failure of patients to give monoclonal antibody C225 or C225 plus Irinotican to continue treatment, results showed that its mitigation rates were up to 10% and 22%, but the latter side effect was high. C225 role in epithelial cell growth factor's receptor, which in the treatment of colorectal cancer should be further exploration of the role will be C225 with FOLFOX or FOLFIRI combination is probably the next step to conduct clinical trials. The second study compared this meeting the most noteworthy of a study, the combined use of a blocking angiogenesis monoclonal antibody Bevacizumab (trade name Avastin) and the IFL than IFL alone to treat metastatic colorectal cancer patients, remission rate can be increased to 35 percent from 45 percent, while the median survival time of 15.6 months may be extended to 20.3 months. The use of Avastin patients more prone to high blood pressure, but the available drugs control, the study is the Buddha Cookman (Folkman) physicians in the 1970s initiated blocking tumor blood vessels can starve to death the first time the theory been tested clinically, but the last one study of Avastin for breast cancer have not shown such efficacy, but also with Avastin + IFL and FOLFOX effects will not be more than better, therefore, clinical use of Avastin might have to wait another several large clinical trials, the results can be confirmed.