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Published on: September 30, 2016
[Current Progress and Feasibility of Using Molecular-Targeted Agent Combinations for Metastatic Colorectal Cancer]
1Dept. of Clinical Oncology, Aichi Cancer Center Hospital.
Abstract:
The efficacy of molecular-targeted agent combinations for the treatment of metastatic colorectal cancer has become increasingly evident over recent years, although none of these combinations have been recognized yet as a standard therapy. The intention here is to provide a synopsis of current progress in this developing area by reviewing existing publications and ongoing clinical trials. While bevacizumab plus anti-EGFR agents exhibit detrimental effects in first-line setting , a combination of bevacizumab with erlotinib has been suggested as an effective maintenance therapy. Dabrafenib plus panitumumab in combination with trametinib and encorafenib plus cetuximab in combination with alpelisib, are very promising combination treatments and are currently being developed in clinical trials for patients with BRAF mutant-type tumors. An earlier nonclinical trial suggested that a combination of panitumumab plus trametinib was effective in patients who were resistant to anti- EGFR agents but developing KRAS- or NRAS-mutated tumors. The HERACLES trial further indicated that a combination of trastuzumab and lapatinib showed promising antitumor effects in patients with emerging HER2 amplification. Other reports suggest that irinotecan and cetuximab in combination with tivantinib were more effective than a combination of irinotecan and cetuximab alone for patients with MET amplification, although further research is needed for this application, as results were based upon the analysis of subgroups. It is clear that data arising from both primary research and clinical trials support the combined use of molecular-targeted drugs in the treatment of metastatic colorectal cancer. As clinical trials progress, it is likely that such treatment combinations will become recognized as standard therapies.
Insights
Combinations of molecular-targeted drugs show promise for metastatic colorectal cancer treatment. Ongoing trials are evaluating these novel therapies, potentially establishing them as future standard care.
Area of Science:
- Oncology
- Medical Genetics
- Pharmacology
Background:
- Metastatic colorectal cancer (mCRC) treatment is evolving with molecular-targeted agents.
- Current combination therapies are not yet standard but show significant promise.
Purpose of the Study:
- To review current progress and ongoing clinical trials of molecular-targeted agent combinations for mCRC.
- To highlight promising combinations for specific genetic mutations and resistance patterns.
Main Methods:
- Review of existing publications on molecular-targeted agent combinations in mCRC.
- Analysis of ongoing clinical trials investigating novel combination therapies.
Main Results:
- Bevacizumab plus erlotinib shows potential as maintenance therapy.
- Combinations like dabrafenib/panitumumab/trametinib and encorafenib/cetuximab/alpelisib are promising for BRAF-mutant mCRC.
- Trastuzumab/lapatinib effective for HER2-amplified mCRC.
- Irinotecan/cetuximab/tivantinib shows potential for MET-amplified mCRC.
Conclusions:
- Data supports the combined use of molecular-targeted drugs for mCRC.
- Further clinical trials are expected to establish these combinations as standard therapies.
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