Continuum of care with anti-angiogenic therapies in metastatic colorectal cancer

摘要: Inhibition of tumor angiogenesis has emerged as an important therapeutic component in the management metastatic colorectal cancer. Three anti-angiogenic agents are currently approved this clinical setting: bevacizumab, ziv-aflibercept, and regorafenib. Bevacizumab, a monoclonal antibody that targets angiogenesis-driving ligand vascular endothelial growth factor A (VEGF-A), is only agent first-line therapy for cancer, where it can be used combination with intravenous 5-fluorouracil-containing chemotherapy regimens. In conjunction second-line chemotherapies, bevacizumab also anti-cancer activity, both cancer patients who received part their first line those naive to it. Ziv-aflibercept demonstrated activity chemotherapeutic regimen FOLFIRI second cancer; functions by binding VEGF-A proteins VEGF-B PIGF (placental factor). Regorafenib, which inhibits multiple tyrosine kinases, including VEGF receptors, proven benefit refractory all other therapies. For patients’ whose cancers therapies, there evidence use fluoropyrimidine monotherapy, but bevacizumab-naive patient subset. Presently, not clear if any one more particular than another, greater efficacy when paired backbone, or subset likely from these agents. Given present tolerance data, should considered lines each specific combinations driving selection.