Evidence-based appraisal of the upfront treatment for unresectable metastatic colorectal cancer patients

Giuseppe Aprile, Stefania Eufemia Lutrino, Laura Ferrari, Mariaelena Casagrande, Marta Bonotto, Elena Ongaro, Fabio Puglisi

Research output: Contribution to journalArticlepeer-review


Colorectal cancer (CRC) is a significant health problem, with around 1 million new cases and 500000 deaths every year worldwide. Over the last two decades, the use of novel therapies and more complex treatment strategies have contributed to progressively increase the median survival of patients with unresectable advanced CRC up to approximately 30 mo. The availability of additional therapeutic options, however, has created new challenges and generated more complicated treatment algorithms. Moreover, several clinically important points are still in debate in first-line, such as the optimal treatment intensity, the most appropriate maintenance strategy, the preferred biologic to be used upfront in patients with KRAS wild-type CRC, and the need for more detailed information on tumor biology. In this moving landscape, this review analyses why the firstline treatment decision is crucial and how the choice may impact on further treatment lines. In addition, it focuses on results of major phase III randomized trials.

Original languageEnglish
Pages (from-to)8474-8488
Number of pages15
JournalWorld Journal of Gastroenterology
Issue number46
Publication statusPublished - Dec 14 2013


  • Angiogenic inhibitors
  • Chemotherapy
  • Colorectal cancer
  • Epidermal growth factor receptor inhibitors
  • First-line
  • Maintenance

ASJC Scopus subject areas

  • Gastroenterology


Dive into the research topics of 'Evidence-based appraisal of the upfront treatment for unresectable metastatic colorectal cancer patients'. Together they form a unique fingerprint.

Cite this