First-line chemotherapy
Yanagisawa Y., Midgley R., Kerr D.
© 2011 Future Medicine Ltd. All rights reserved. All patients with metastatic colorectal cancer (mCRC) should be considered by a multidisciplinary team as the recent development of colorectal cancer management can bring the potential for a cure in patients with mCRC. Combination of 5-fluorouracil plus either oxaliplatin or irinotecan therapy is the standard first-line treatment for mCRC for those patients who can tolerate it as it can deliver the highest response rates. Combination of cetuximab with either oxaliplatin or irinotecan-based chemotherapy is a sensible strategy if metastases are limited and potentially could become resectable. The KRAS wild-type genotype is a strong predictor of efficacy of cetuximab, it is therefore essential to perform KRAS testing before cetuximab treatment is started. How long the initial 'induction treatment' should be and whether chemotherapy-free intervals are appropriate are issues that remain under consideration.