Sequencing of antiangiogenic agents in the treatment of metastatic colorectal cancer.

摘要: Abstract Significant advances have been made with respect to our understanding of the critical role agents targeting angiogenic pathways in treatment metastatic colorectal cancer (mCRC). The approval 3 that target signaling, bevacizumab, ziv-aflibercept, and regorafenib, provides strong evidence angiogenesis is an important process mCRC. addition bevacizumab combination chemotherapy first- second-line mCRC has resulted meaningful improvement overall progression-free survival. standard care for evolved incorporate cytotoxic as backbone regimens (eg, FOLFOX [folinic acid, 5-fluorouracil, oxaliplatin], FOLFIRI irinotecan]) or without epidermal growth factor receptor–targeted therapies cetuximab, panitumumab) setting wild-type KRAS . development ziv-aflibercept improved clinical efficacy Regorafenib, a small-molecule multikinase inhibitor, recently approved by US Food Drug Administration single-agent therapy refractory progressive Each of these integrated into evidence-based—albeit, still evolving—treatment continuum initial treatment, after first progression, second progression. However, most effective strategy use these agents, others remains unclear. This review overview current antiangiogenic