New drugs for the treatment of metastatic colorectal cancer

Abstract

Colorectal cancer (CRC) represents one of the most frequent malignancies in terms of incidence and mortality, thus representing the third leading cause of cancer death worldwide. In the last decade, few drugs have enriched the treatment landscape of metastatic CRC and have significantly affected prognosis. Unlike other neoplasms, metastatic CRC patients who have exhausted treatment options often still maintain a good performance status. There are many challenges to increasing potential treatment options, notably a better understanding of disease biology and the mechanisms of resistance underlying cancer treatment failure. The development of new drugs for metastatic CRC certainly represents one of the most important challenges in medical oncology. This article discusses the main limitations in the development of new drugs and potential future scenarios. In particular, we addressed three questions: (1) The main limitations of targeted therapy in the treatment of metastatic CRC (mCRC); (2) New target armamentarium that could escape primary and secondary resistance and lead to more personalized mCRC therapy; and (3) Future directions.

Keywords: Colon cancer; Colon rectal cancer; New drugs; Drug resistance; Metastatic colorectal cancer

Core Tip: Although metastatic colorectal cancer (CRC) is a relevant oncological issue, few drugs have changed clinical practice in the last decade. In fact, there are many difficulties in the development of new drugs closely related to the biology of CRC; however, improved knowledge of the molecular biology of this cancer has led to a few steps forward and the hope for more targeted cancer treatments for metastatic CRC patients in the near future.