Published online Feb 24, 2019. doi: 10.5306/wjco.v10.i2.52
Peer-review started: September 25, 2018
First decision: November 1, 2018
Revised: November 8, 2018
Accepted: January 5, 2019
Article in press: January 6, 2019
Published online: February 24, 2019
Processing time: 153 Days and 17.3 Hours
Continuous inhibition of angiogenesis beyond progression is an emerging treatment concept in the management of metastatic colorectal cancer patients with prior bevacizumab exposure. Treatment options include the continuation or reintroduction of bevacizumab during the second-line chemotherapy or switching to a different antiangiogenic monoclonal antibody such as aflibercept or ramucirumab. In the selection of treatment, patient-based factors such as performance status, age, tumor burden, and tolerance and sensitivity to the first-line bevacizumab-based therapy, as well as treatment-related factors such as toxicity, efficacy, and cost, should be taken into consideration.
Core tıp: Anti-angiogenic treatment is an essential part of the current armamentarium against metastatic colorectal cancer (mCRC). For now, bevacizumab is the only drug licensed for the treatment of chemotherapy-naïve patients with mCRC. However, patients undergoing first-line bevacizumab-based therapy eventually develop disease progression and become candidates for second-line chemotherapy. In this manuscript, we discuss the available anti-angiogenic therapeutic strategies that have been proven to be useful in the treatment of patients with mCRC in whom first-line bevacizumab-based therapy was ineffective.