Targeted therapy in colorectal cancer

Abstract

Our understanding of the molecular pathways that mediate cancer cell proliferation has increased significantly and with this comes the rapid development of molecular targeted therapies. The epidermal growth factor receptor and the vascular endothelial growth factor are two such targets that have proven to be important in the treatment of advanced colorectal cancer. Successful inhibition of these targets, utilising monoclonal antibodies bevacizumab, cetuximab and panitumumab, has led to improved patient outcomes. Prolongation of patient survival and improvement in quality of life has been associated with the use of these antibodies. Such therapies are now becoming part of standard management of advanced colorectal malignancy. Predictive biomarkers that allow for a more rational and effective utilisation of these new molecular targeted therapies are being discovered. The number of potential molecular targets seems infinite as new drugs are rapidly processed through new accelerated clinical trial designs and drug development programs. Many challenges remain in the successful development of molecular targeted therapies, including overcoming mechanisms of resistance, optimal drug delivery, the issues of the financial cost of these new drugs and equitable access to the new therapies.