[Novel molecular approaches in the therapy of advanced colorectal carcinoma]

Therapeutic options for patients with metastatic colorectal cancer have clearly improved during the last years. The regular use of irinotecan and oxaliplatin in first- and second-line treatment led to a clear improvement of median overall survival time. For the first time a new therapeutic concept--the inhibition of tumor angiogenesis--has been realized for clinical use by combining the anti-VEGF monoclonal antibody bevacizumab with an irinotecan-based first-line therapy. The monoclonal antibody cetuximab, targeted against EGFR, offers another new and very effective therapeutic option to patients with advanced irinotecan-refractory colorectal cancer--even those who are already pretreated with oxaliplatin. Further clinical studies are going to evaluate the future role of these new molecular treatment options as part of those therapeutic possibilities which are already available and established for the treatment of colorectal cancer patients with advanced disease (such as the optimal sequencing, the role of orale fluoropyrimidine-based combination therapy with cetuximab or bevacizumab).