[Colorectal cancer - personalized, stage-adjusted tumour therapy].

Pohl M, Schmiegel W.

Dtsch Med Wochenschr. 2013 Sep;138(36):1790-5. 

Source

Medizinische Universitätsklinik, Knappschaftskrankenhaus Bochum.

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer death in the western world. Every second patient dies of the disease. The introduction of new and effective chemotherapeutic substances and biologics during the past decade has significantly improved the systemic treatment of patients with CRC. In stage III colon cancer combination chemotherapy with oxaliplatin is the standard of care. Primary resection of metastases or resection after combination therapy and downsizing of lesions offers a chance for cure for some patients. In the treatment of rectal carcinoma, multimodality and neoadjuvant treatment concepts have replaced adjuvant chemoradio-therapy for locally advanced rectal cancer. In the palliative setting intensive combination treatment is indicated in colorectal cancer if tumor related symptoms or a rapid progress of the disease occur. 

The aim of palliative therapy is the prolongation of survival and the improvement of quality of life. 

The introduction of the mutational status of the KRAS oncogene as the first predictive marker into clinical care is an important step towards the personalization of treatment in CRC.