Review of systemic therapies for locally advanced and metastatic rectal cancer

Patrick Yaffee, Arsen Osipov, Carlyn Tan, Richard Tuli, Andrew Hendifar

Research output: Contribution to journalArticlepeer-review

Abstract

Rectal cancer, along with colon cancer, is the second leading cause of cancer-related deaths in the U.S. Up to a quarter of patients have metastatic disease at diagnosis and 40% will develop metastatic disease. The past 10 years have been extremely exciting in the treatment of both locally advanced and metastatic rectal cancer (mRC). With the advent of neoadjuvant chemoradiation, increased numbers of patients with locally advanced rectal cancer (LARC) are surviving longer and some are seeing their tumors shrink to sizes that allow for resection. The advent of biologics and monoclonal antibodies has propelled the treatment of mRC further than many could have hoped. Combined with regimens such as FOLFOX or FOLFIRI, median survival rates have been increased to an average of 23 months. However, the combinations of chemotherapy regimens seem endless for rectal cancer. We will review the major chemotherapies available for locally advanced and mRC as well as regimens currently under investigation such as FOLFOXIRI. We will also review vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) inhibitors as single agents and in combination with traditional chemotherapy regimens.

Original languageEnglish (US)
Pages (from-to)185-200
Number of pages16
JournalJournal of Gastrointestinal Oncology
Volume6
Issue number2
DOIs
StatePublished - 2015
Externally publishedYes

Keywords

  • chemotherapies
  • locally advanced and metastatic rectal cancer (mRC)
  • Systemic therapies

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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