Skip to main content
Erschienen in:

22.10.2018 | short review

Cure in metastatic disease: how to manage and who is the right patient in colorectal cancer?

verfasst von: Thomas Gruenberger, Phillip Jonas, Rebecca Lutz, Birgit Gruenberger

Erschienen in: memo - Magazine of European Medical Oncology | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Summary

Metastatic colorectal cancer was long considered for palliative therapy, until significant improvement in surgical techniques and more effective chemotherapeutic regimens changed the way metastatic colon cancer patients are being treated today. Prospective trials were designed to answer the question which patient with metastatic disease could potentially be cured by a multidisciplinary approach with medical oncologists, surgeons and radiation oncology using an induction chemotherapy in combination with a targeted agent and being monitored for resectability in multidisciplinary tumor boards. Patients with oligometastatic disease should be treated with the goal of curative resection. This review will highlight studies conducted over the past 15 years addressing this issue. An algorithm is proposed illustrating how every newly diagnosed mCRC (metastatic colorectal cancer) patient could be discussed in the tumor board to decide the best treatment sequence with the best chance of cure.
Literatur
1.
Zurück zum Zitat Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371:1007–16.CrossRefPubMedPubMedCentral Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371:1007–16.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013;14:1208–15.CrossRefPubMed Nordlinger B, Sorbye H, Glimelius B, et al. Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013;14:1208–15.CrossRefPubMed
3.
Zurück zum Zitat Gruenberger B, Tamandl D, Schueller J, et al. Bevacizumab, capecitabine, and oxaliplatin as neoadjuvant therapy for patients with potentially curable metastatic colorectal cancer. J Clin Oncol. 2008;26:1830–5.CrossRefPubMed Gruenberger B, Tamandl D, Schueller J, et al. Bevacizumab, capecitabine, and oxaliplatin as neoadjuvant therapy for patients with potentially curable metastatic colorectal cancer. J Clin Oncol. 2008;26:1830–5.CrossRefPubMed
4.
Zurück zum Zitat Hubert C, Sempoux C, Humblet Y, et al. Sinusoidal obstruction syndrome (SOS) related to chemotherapy for colorectal liver metastases: factors predictive of severe SOS lesions and protective effect of bevacizumab. HPB (Oxford). 2013;15:858–64.CrossRef Hubert C, Sempoux C, Humblet Y, et al. Sinusoidal obstruction syndrome (SOS) related to chemotherapy for colorectal liver metastases: factors predictive of severe SOS lesions and protective effect of bevacizumab. HPB (Oxford). 2013;15:858–64.CrossRef
5.
Zurück zum Zitat Klinger M, Tamandl D, Eipeldauer S, et al. Bevacizumab improves pathological response of colorectal cancer liver metastases treated with XELOX/FOLFOX. Ann Surg Oncol. 2010;17:2059–65.CrossRefPubMed Klinger M, Tamandl D, Eipeldauer S, et al. Bevacizumab improves pathological response of colorectal cancer liver metastases treated with XELOX/FOLFOX. Ann Surg Oncol. 2010;17:2059–65.CrossRefPubMed
6.
Zurück zum Zitat Viganò L, Capussotti L, De Rosa G, et al. Liver Resection for Colorectal Metastases after Chemotherapy: Impact of Chemotherapy-Related Liver Injuries, Pathological Tumor Response, and Micrometastases on Long-term Survival. Ann Surg. 2013;258:731–42.CrossRefPubMed Viganò L, Capussotti L, De Rosa G, et al. Liver Resection for Colorectal Metastases after Chemotherapy: Impact of Chemotherapy-Related Liver Injuries, Pathological Tumor Response, and Micrometastases on Long-term Survival. Ann Surg. 2013;258:731–42.CrossRefPubMed
7.
Zurück zum Zitat Gruenberger T, Beets G, Van Laethem J‑L, et al. Treatment sequence of synchronously (liver) metastasized colon cancer. Dig Liver Dis. 2016;48:1119–23.CrossRefPubMed Gruenberger T, Beets G, Van Laethem J‑L, et al. Treatment sequence of synchronously (liver) metastasized colon cancer. Dig Liver Dis. 2016;48:1119–23.CrossRefPubMed
8.
Zurück zum Zitat Nordlinger B, Van Cutsem E, Gruenberger T, et al. Combination of surgery and chemotherapy and the role of targeted agents in the treatment of patients with colorectal liver metastases: recommendations from an expert panel. Ann Oncol. 2009;20:985–92.CrossRefPubMed Nordlinger B, Van Cutsem E, Gruenberger T, et al. Combination of surgery and chemotherapy and the role of targeted agents in the treatment of patients with colorectal liver metastases: recommendations from an expert panel. Ann Oncol. 2009;20:985–92.CrossRefPubMed
9.
Zurück zum Zitat Masi G, Vasile E, Loupakis F, et al. Randomized trial of two induction chemotherapy regimens in metastatic colorectal cancer: an updated analysis. J Natl Cancer Inst. 2011;103:21–30.CrossRefPubMed Masi G, Vasile E, Loupakis F, et al. Randomized trial of two induction chemotherapy regimens in metastatic colorectal cancer: an updated analysis. J Natl Cancer Inst. 2011;103:21–30.CrossRefPubMed
10.
Zurück zum Zitat Cremolini C, Loupakis F, Masi G, et al. FOLFOXIRI or FOLFOXIRI plus bevacizumab as first-line treatment of metastatic colorectal cancer: a propensity score-adjusted analysis from two randomized clinical trials. Ann Oncol. 2016;27:843–9.CrossRefPubMed Cremolini C, Loupakis F, Masi G, et al. FOLFOXIRI or FOLFOXIRI plus bevacizumab as first-line treatment of metastatic colorectal cancer: a propensity score-adjusted analysis from two randomized clinical trials. Ann Oncol. 2016;27:843–9.CrossRefPubMed
11.
Zurück zum Zitat Gruenberger T, Bridgewater J, Chau I, et al. Bevacizumab plus mFOLFOX-6 or FOLFOXIRI in patients with initially unresectable liver metastases from colorectal cancer: the OLIVIA multinational randomised phase II trial. Ann Oncol. 2015;26:702–8.CrossRefPubMed Gruenberger T, Bridgewater J, Chau I, et al. Bevacizumab plus mFOLFOX-6 or FOLFOXIRI in patients with initially unresectable liver metastases from colorectal cancer: the OLIVIA multinational randomised phase II trial. Ann Oncol. 2015;26:702–8.CrossRefPubMed
12.
Zurück zum Zitat Folprecht G, Hamann S, Schütte K, et al. Dose escalating study of cetuximab and 5‑FU/folinic acid (FA)/oxaliplatin/irinotecan (FOLFOXIRI) in first line therapy of patients with metastatic colorectal cancer. BMC Cancer. 2014;14:521.CrossRefPubMedPubMedCentral Folprecht G, Hamann S, Schütte K, et al. Dose escalating study of cetuximab and 5‑FU/folinic acid (FA)/oxaliplatin/irinotecan (FOLFOXIRI) in first line therapy of patients with metastatic colorectal cancer. BMC Cancer. 2014;14:521.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Cremolini C, Antoniotti C, Lonardi S, et al. Activity and safety of cetuximab plus modified folfoxiri followed by maintenance with cetuximab or bevacizumab for ras and braf wild-type metastatic colorectal cancer: A randomized phase 2 clinical trial. JAMA Oncol. 2018;4:529–36.CrossRefPubMedPubMedCentral Cremolini C, Antoniotti C, Lonardi S, et al. Activity and safety of cetuximab plus modified folfoxiri followed by maintenance with cetuximab or bevacizumab for ras and braf wild-type metastatic colorectal cancer: A randomized phase 2 clinical trial. JAMA Oncol. 2018;4:529–36.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Fornaro L, Lonardi S, Masi G, et al. FOLFOXIRI in combination with panitumumab as first-line treatment in quadruple wild-type (KRAS, NRAS, HRAS, BRAF) metastatic colorectal cancer patients: a phase II trial by the Gruppo Oncologico Nord Ovest (GONO). Ann Oncol. 2013;24:2062–7.CrossRefPubMed Fornaro L, Lonardi S, Masi G, et al. FOLFOXIRI in combination with panitumumab as first-line treatment in quadruple wild-type (KRAS, NRAS, HRAS, BRAF) metastatic colorectal cancer patients: a phase II trial by the Gruppo Oncologico Nord Ovest (GONO). Ann Oncol. 2013;24:2062–7.CrossRefPubMed
15.
Zurück zum Zitat Modest DP, Denecke T, Pratschke J, et al. Surgical treatment options following chemotherapy plus cetuximab or bevacizumab in metastatic colorectal cancer—central evaluation of FIRE-3. Eur J Cancer. 2018;88:77–86.CrossRefPubMed Modest DP, Denecke T, Pratschke J, et al. Surgical treatment options following chemotherapy plus cetuximab or bevacizumab in metastatic colorectal cancer—central evaluation of FIRE-3. Eur J Cancer. 2018;88:77–86.CrossRefPubMed
16.
Zurück zum Zitat Andres A, Mentha G, Adam R, et al. Surgical management of patients with colorectal cancer and simultaneous liver and lung metastases. Br J Surg. 2015;102:691–9.CrossRefPubMed Andres A, Mentha G, Adam R, et al. Surgical management of patients with colorectal cancer and simultaneous liver and lung metastases. Br J Surg. 2015;102:691–9.CrossRefPubMed
17.
Zurück zum Zitat Brouquet A, Vauthey JN, Contreras CM, et al. Improved survival after resection of liver and lung colorectal metastases compared with liver-only metastases: a study of 112 patients with limited lung metastatic disease. J Am Coll Surg. 2011;213:62–9.CrossRefPubMed Brouquet A, Vauthey JN, Contreras CM, et al. Improved survival after resection of liver and lung colorectal metastases compared with liver-only metastases: a study of 112 patients with limited lung metastatic disease. J Am Coll Surg. 2011;213:62–9.CrossRefPubMed
18.
Zurück zum Zitat Karoui M, Penna C, Amin-Hashem M, et al. Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg. 2006;243:1–7.CrossRefPubMedPubMedCentral Karoui M, Penna C, Amin-Hashem M, et al. Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg. 2006;243:1–7.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Ruers T, Van Coevorden F, Punt CJA, et al. Local treatment of unresectable colorectal liver metastases: results of a randomized phase II trial. J Natl Cancer Inst. 2017;109:djx15.PubMedCentral Ruers T, Van Coevorden F, Punt CJA, et al. Local treatment of unresectable colorectal liver metastases: results of a randomized phase II trial. J Natl Cancer Inst. 2017;109:djx15.PubMedCentral
20.
Zurück zum Zitat Wicherts DA, de Haas RJ, Salloum C, et al. Repeat hepatectomy for recurrent colorectal metastases. Br J Surg. 2013;100:808–18.CrossRefPubMed Wicherts DA, de Haas RJ, Salloum C, et al. Repeat hepatectomy for recurrent colorectal metastases. Br J Surg. 2013;100:808–18.CrossRefPubMed
Metadaten
Titel
Cure in metastatic disease: how to manage and who is the right patient in colorectal cancer?
verfasst von
Thomas Gruenberger
Phillip Jonas
Rebecca Lutz
Birgit Gruenberger
Publikationsdatum
22.10.2018
Verlag
Springer Vienna
Erschienen in
memo - Magazine of European Medical Oncology / Ausgabe 4/2018
Print ISSN: 1865-5041
Elektronische ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-018-0443-8