Published online Jul 15, 2014. doi: 10.4251/wjgo.v6.i7.211
Revised: March 4, 2014
Accepted: May 29, 2014
Published online: July 15, 2014
Processing time: 229 Days and 0.2 Hours
During the last decade we have witnessed an unprecedented outburst of new treatment approaches for the management of metastatic colon cancer. Anti-angiogenic drugs, epidermal growth factor receptor blockers and multi-kinase inhibitors have all resulted in small but consistent improvement in clinical outcomes. However, this progress has paradoxically leaded us into new challenges. In many cases the clinical development was done in parallel and the lack of head-to-head comparison evolved into circumstances where several valid new “standards of care” are available. Even though desirable in essence, the availability of many options as well as different possible combinations frequently leaves the busy clinician in the difficult situation of having to choose between one or the other, sometimes without solid evidence to support each decision. In addition, progress never stops and new agents are continuously tested. For these reason this review will try to summarize all the clinical trials that constitute the theoretical framework that support our daily practice but will also procure the reader with rational answers to common clinical dilemmas by critically appraising the current literature. Lastly, we will provide with a compilation of promising new agents that may soon become our next line of defense against this deadly disease.
Core tip: This manuscript is a comprehensive review, with the most updated information up to 2014, regarding metastatic colon cancer. It summarizes all those relevant clinical trials that constitute the theoretical framework to support our daily practice and provides rational answers to common clinical dilemmas. Additionally, it gives the reader a compilation of potential new agents that are currently being tested and may soon become the next step in the battle against this disease.