Methods of overcoming treatment resistance in colorectal cancer
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Abstract
Metastatic colorectal cancer remains a lethal disease with a poor prognosis in the majority of patients. Multiple drug combinations have been developed in recent years that have significantly improved response rates and overall survival however resistance to these drugs is inevitable. Novel agents are currently being developed and participation in clinical trials should be encouraged. In the absence of other treatment options in a patient with good performance status, there is compelling evidence for re-challenging with previously administered agents in different combinations. The aim of this review is to discuss mechanisms of resistance and methods to overcome treatment resistance in patients with metastatic colorectal cancer who are refractory to 5-FU, irinotecan, oxaliplatin, cetuximab and bevacizumab therapy. © 2013 Elsevier Ireland Ltd.
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5-fluorouracil, Bevacizumab, Cetuximab, Drug resistance, Irinotecan, Overcome resistance, Oxaliplatin, Re-challenge, Antibodies, monoclonal, humanized, Antineoplastic agents, Antineoplastic combined chemotherapy protocols, Camptothecin, Colon, Colorectal neoplasms, Drug resistance, neoplasm, Fluorouracil, Humans, Organoplatinum compounds, Rectum, Aflibercept, B raf kinase, Capecitabine, Epidermal growth factor receptor, Excision repair cross complementing protein 1, Folinic acid, K ras protein, Lapatinib, Phosphatidylinositol 3 kinase, Phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase, Regorafenib, Ribonucleotide reductase, Sorafenib, Thymidylate synthase, Cancer chemotherapy, Cancer combination chemotherapy, Cancer growth, Cancer resistance, Colorectal cancer, Continuous infusion, Diarrhea, Disease course, Disease severity, Dna repair, Dose response, Drug dose escalation, Drug efficacy, Drug exposure, Drug megadose, Drug potentiation, Drug targeting, Enzyme activity, Enzyme inhibition, Fatigue, Gene mutation, Human, Long term exposure, Metastatic colorectal cancer, Monotherapy, Nausea, Neurotoxicity, Neutropenia, Nonhuman, Oncogene k ras, Overall survival, Phase 2 clinical trial (topic), Phase 3 clinical trial (topic), Progression free survival, Rash, Review, Skin manifestation, Treatment response, Unspecified side effect, Vomiting, Wild type