[Transition of chemotherapy for metastatic colorectal cancer and recent advances]

Chemotherapy for colorectal cancer (CRC) was representative of the cancer unable to expect achieving response in previous times. When 5-fluorouracil and leucovorin were the sole therapeutic options in past years, the median overall survival times (MST) of CRC were stagnant, at approximately 8 to 12 months. However, with development and introduction of new anticancer drugs such as irinotecan or oxaliplatin and molecular targeting drugs such as bevacizumab or anti-EGFR antibodies (cetuximab and panitumumab) in last decade, the MST have much improved. Recent published phase III trials of combination regimens in untreated metastatic CRC have demonstrated substantial improvements with MST now ranging between 18 and 24 months. In addition, a second development is the increased recognition that surgically resecting liver-limited metastases following the administration of such effective chemotherapy may substantially improve long-term outcomes. By continued advances in pharmaceutical development combined with appropriate use of liver resection, we hope that these gains may be amplified and extended to further improve patient survival.