Emerging therapies for rectal cancer

Preoperative treatment with either short‐course radiotherapy or chemo‐radiotherapy (CRT) is used routinely in some centres to reduce local recurrence rates in patients with operable rectal cancer prior to optimal surgery. However, there is a need for new treatment strategies to further improve the outcomes of these patients, particularly with regard to survival. Advances in the treatment of metastatic disease, such as the use of combination chemotherapy with oxaliplatin and irinotecan, and the targeted agents bevacizumab and cetuximab, have led to clinical research into alternative radio‐sensitizers during CRT and the novel use of neo‐adjuvant (preoperative) chemotherapy prior to preoperative CRT and surgery. Whilst these remain experimental, it is likely that these will serve as a platform for developing an expanded range of treatment options so that clinicians will be better able to tailor treatment to the needs of different patients.

[1]  C. Sempoux,et al.  Phase I/II study of preoperative cetuximab, capecitabine, and external beam radiotherapy in patients with rectal cancer. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[2]  A. Norman,et al.  Neoadjuvant capecitabine and oxaliplatin followed by synchronous chemoradiation and total mesorectal excision in magnetic resonance imaging-defined poor-risk rectal cancer. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  J. Tabernero,et al.  Cetuximab in combination with oxaliplatin/5-fluorouracil (5FU)/folinic acid (FA) (FOLFOX-4) in the first-line treatment of patients with epidermal growth factor receptor (EGFR)-expressing metastatic colorectal cancer: An international phase II study. , 2005 .

[4]  Armando Santoro,et al.  Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. , 2004, The New England journal of medicine.

[5]  Christopher U. Jones,et al.  Cetuximab prolongs survival in patients with locoregionally advanced squamous cell carcinoma of head and neck: A phase III study of high dose radiation therapy with or without cetuximab. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  J. Berlin,et al.  Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. , 2004, The New England journal of medicine.

[7]  A. Norman,et al.  Neoadjuvant systemic fluorouracil and mitomycin C prior to synchronous chemoradiation is an effective strategy in locally advanced rectal cancer , 2003, British Journal of Cancer.

[8]  J P Pignon,et al.  Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. , 2001, The New England journal of medicine.

[9]  L. Saltz,et al.  Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. , 2000, The New England journal of medicine.

[10]  C. Wilson,et al.  Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  R. James,et al.  Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial , 2000, The Lancet.