What is the Optimal Treatment for Metastatic Colorectal Cancer? Controversial Points
Esther Uña Cidón*
Clinical Oncology Department, Faculty of Medicine, Clinical University Hospital of Valladolid, Spain
- *Corresponding Author:
- Esther Uña Cidón, MD, PhD
Professor, Clinical Oncology Department
Clinical University Hospital and Faculty of Medicine
C/ Ramon y Cajal s/n, 47005 Valladolid, Spain
Tel: 34 678938050
E-mail: [email protected]
Received Date: October 03, 2011; Accepted Date: November 14, 2011; Published Date: November 16, 2011
Citation: Cidón EU (2011) What is the Optimal Treatment for Metastatic Colorectal Cancer? Controversial Points. J Cancer Sci Ther S4:003. doi:10.4172/1948-5956.S4-003
Copyright: © 2011 Cidón EU. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Colorectal cancer (CRC) is the second leading cause of death from cancer in the developed countries. Although great efforts have been made to achieve an early diagnosis, a large number of cases will present metastases. The natural history of metastatic (m) CRC has dramatically evolved in the recent years thanks to the introduction of modern chemotherapy and molecular therapies. With these agents the response rate has increased to 50% and survival has been improved not only progression free survival (PFS), which has reached 12 months, but also overall survival (OS) which is longer than 2 years. Despite this progress many questions remain to be answered, mainly those related to the sequential regimens, drug rotation, alternant or intermitent schedules, optimal duration of chemotherapy, the role of maintenance chemotherapy and the role of doublets or triplets. The optimal duration of chemotherapy is very important because it has a direct influence on the patient quality of life, survival and costs. There are several studies addressing this topic and the alternatives we have, such as “stop and go”, intermittent strategies or maintenance of only several agents and these studies reinforce the frequent behaviour of the oncologists to stop the treatment when the patient has obtained the maximum response. But there are some methodological problems in the analyzed trials which have determined that not all the professionals agree with this proposal. With this context it is essential to perform well designed clinical trials incorporating new drugs and addressing these questions. This article tries to review briefly all these controversial points.