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Methods of overcoming treatment resistance in colorectal cancer

Sally Temraz1, Deborah Mukherji1, Raafat Alameddine1

  • 1American University of Beirut Medical Center (AUBMC), Lebanon.

Critical Reviews in Oncology/Hematology
|October 1, 2013
PubMed

Insights

Metastatic colorectal cancer treatment resistance is inevitable. This review explores overcoming resistance to common therapies like 5-FU, irinotecan, oxaliplatin, cetuximab, and bevacizumab in refractory patients.

Area of Science:

  • Oncology
  • Medical Research

Background:

  • Metastatic colorectal cancer (mCRC) presents a significant survival challenge.
  • Current combination therapies improve outcomes but inevitably lead to drug resistance.
  • Novel therapeutic agents and clinical trials offer future hope for mCRC patients.

Purpose of the Study:

  • To review mechanisms of treatment resistance in metastatic colorectal cancer.
  • To discuss strategies for overcoming resistance to 5-fluorouracil (5-FU), irinotecan, oxaliplatin, cetuximab, and bevacizumab.
  • To explore the potential of re-challenging with previously administered agents in refractory mCRC.

Main Methods:

  • Literature review of studies on drug resistance in metastatic colorectal cancer.
  • Analysis of mechanisms underlying resistance to standard mCRC chemotherapies and targeted agents.
  • Evaluation of clinical evidence for re-treatment strategies in patients refractory to first-line therapies.

Main Results:

  • Drug resistance in mCRC involves complex molecular and cellular mechanisms.
  • Cross-resistance and acquired resistance limit the efficacy of standard treatments.
  • Re-challenging with prior agents in novel combinations shows promise in select patient populations.

Conclusions:

  • Understanding resistance mechanisms is crucial for developing effective mCRC treatments.
  • Innovative therapeutic strategies are needed to overcome acquired resistance.
  • Clinical trial participation and exploring re-treatment options are vital for refractory mCRC patients.
Keywords:
5-FluorouracilBevacizumabCetuximabDrug resistanceIrinotecanOvercome resistanceOxaliplatinRe-challenge

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