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Systemic therapy for advanced colorectal cancer 

Systemic therapy for advanced colorectal cancer
Chapter:
Systemic therapy for advanced colorectal cancer
Author(s):

Fiona Collinson

, Peter Hall

, Mike Braun

, and Daniel Swinson

DOI:
10.1093/med/9780199590209.003.0007
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date: 29 October 2020

Over the past two decades the median overall survival for patients with advanced colorectal cancer has increased from 6 months without treatment to 2 years with modern systemic therapies

The standard chemotherapy armamentarium includes fluoropyrimidines, oxaliplatin and irinotecan delivered in two lines of treatment. Irinotecan and fluoropyrimidines have single agent activity but oxaliplatin is only effective in combination with a second drug

Infusional 5-fluorouracil can be substituted with capecitabine without loss of efficacy. Caution should be exercised in the elderly and in the presence of even modest renal impairment

Controversy persists on the worth of newer biological drugs targeting EGFR and VEGF

Current research aims to identify new agents and develop a tailored approach dependent on predictive clinicopathological and biological markers.

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