Perioperative Chemotherapy for Liver Metastasis of Colorectal Cancer
A special issue of Cancers (ISSN 2072-6694).
Deadline for manuscript submissions: closed (31 August 2020) | Viewed by 8062
Special Issue Editor
Interests: adenocarcinoma of the colon and rectum
Special Issues, Collections and Topics in MDPI journals
Special Issue Information
Dear Colleagues,
In recent decades, the treatment for metastatic colorectal cancer (mCRC) has remarkably progressed with the advent of biological agents. Nowadays the median survival time of mCRC patients is over 30 months. Under such circumstances, it becomes a key issue which biological agent is a preferred treatment, especially for first-line treatment of mCRC patients with RAS wild-type tumor. For unresectable diseases, preferred treatment depends on treatment goal; patients should be treated to seek for maximum shrinkage, or treatment duration. If the former, anti-EGFR mab might be a preferred option in terms of depth of response. If the latter, bevacizumab (BEV) might be preferred in terms of maintenance therapy.
For unresectable liver limited diseases, a similar strategy for treatment can be recommended. There are several types of liver metastases (LM). If LM is bulky and unresectable, a tumor shrinkage is supposed to be needed so that LM can be converted to be resectable. If LM is disseminated and unresectable, a pathological effect is supposed to be to prevent recurrence after liver resection. If the former, anti-EGFR mab might be preferred and if the latter, bevacizumab might be better, considering characteristics of biological agents. We have to consider a preferred treatment option according to a real clinical case.
In ATOM trial, a randomized phase II study of mFOLFOX6 plus BEV versus mFOLFOX6 plus cetuximab (CET) for liver-limited metastatic colorectal cancer that is unsuitable for upfront resection, BEV and CET showed a similar efficacy in PFS and liver resection rate, though greater tumor shrinkage was observed in CET group.
Prof. Dr. Hiroyuki Uetake
Guest Editor
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Keywords
- Perioperative combination chemotherapy
- bevacizumab
- anti-EGFR
- depth of response
- pathological response
- conversion
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