Adaptation of international guidelines for metastatic colorectal cancer: An Asian consensus

Ann Lii Cheng, Jin Li, Ashok K. Vaid, Brigette Buig Yue Ma, Catherine Teh, Joong B. Ahn, Maximino Bello, Chaiyut Charoentum, Li Tzong Chen, Gilberto De Lima Lopes, Gwo F. Ho, Hwai L. Kong, Ka O. Lam, Tian S. Liu, Young S. Park, Virote Sriuranpong, Aru W. Sudoyo, Jaw Yuan Wang, Jun Zhang, Su Z. ZhangFortunato Ciardiello, Clause Henning Köhne, Michael Shaw, Tae Won Kim

Research output: Contribution to journalComment/debate

Abstract

Colorectal cancer (CRC) is among the most common cancers worldwide, but marked epidemiological differences exist between Asian and non-Asian populations. Hence, a consensus meeting was held in Hong Kong in December 2012 to develop Asia-specific guidelines for the management of metastatic CRC (mCRC). A multidisciplinary expert panel, consisting of 23 participants from 10 Asian and 2 European countries, discussed current guidelines for colon or rectal cancer and developed recommendations for adapting these guidelines to Asian clinical practice. Participants agreed that mCRC management in Asia largely follows international guidelines, but they proposed a number of recommendations based on regional 'real-world' experience. In general, participants agreed that 5-fluorouracil (5-FU) infusion regimens in doublets can be substituted with UFT (capecitabine, tegafur-uracil) and S1 (tegafur, 5-chloro-2,4-dihydroxypyridine and oxonic acid), and that the monoclonal antibodies cetuximab and panitumumab are recommended for KRAS wild type tumors. For KRAS mutant tumors, bevacizumab is the preferred biological therapy. FOLFOX (folinic acid, 5-FU, and oxaliplatin) is preferred for initial therapy in Asian patients. The management of mCRC is evolving, and it must be emphasized that the recommendations presented here reflect current treatment practices and thus might change as more data become available.

Original languageEnglish (US)
Pages (from-to)145-155
Number of pages11
JournalClinical colorectal cancer
Volume13
Issue number3
DOIs
StatePublished - Sep 1 2014

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Keywords

  • Asia
  • Chemotherapy
  • Epidermal growth factor receptor (EGFR)-specific monoclonal antibody
  • KRAS
  • Targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Cheng, A. L., Li, J., Vaid, A. K., Ma, B. B. Y., Teh, C., Ahn, J. B., Bello, M., Charoentum, C., Chen, L. T., De Lima Lopes, G., Ho, G. F., Kong, H. L., Lam, K. O., Liu, T. S., Park, Y. S., Sriuranpong, V., Sudoyo, A. W., Wang, J. Y., Zhang, J., ... Kim, T. W. (2014). Adaptation of international guidelines for metastatic colorectal cancer: An Asian consensus. Clinical colorectal cancer, 13(3), 145-155. https://doi.org/10.1016/j.clcc.2014.06.004