Skip to main content
Erschienen in:

01.12.2009 | Leitthema

Therapie des metastasierten Kolonkarzinoms

verfasst von: PD Dr. G. Folprecht, C. Bokemeyer, J. Weitz

Erschienen in: Die Onkologie | Ausgabe 12/2009

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die systemische Therapie des metastasierten Kolonkarzinoms und die operativen Techniken insbesondere der Lebermetastasenresektion haben sich in den letzten Jahren kontinuierlich verbessert. Die Kombination aus einer Resektion von Metastasen und der sequenzielle Einsatz der neuen medikamentösen Therapieoptionen erzielt heute im Median Überlebenszeiten von 24–30 Monaten. Mit der Resektion von (Leber-)Metastasen ist für einen Teil der Patienten heute sogar eine Heilung möglich. Daher sollte diese Option bei allen Patienten mit isolierten Leber-/Lungenmetastasen vor Beginn der Chemotherapie oder bei initial nichtresektablen Metastasen im Verlauf der systemischen Therapie überprüft werden. In der medikamentösen Behandlung führten Antikörper gegen VEGF oder den EGF-Rezeptor zu einer Steigerung der Effektivität. Durch die Bestimmung des K-RAS-Mutationsstatus im Tumor kann eine rationale Auswahl von Patienten getroffen werden, die nicht (K-RAS-mutiert) bzw. stärker (K-RAS-Wildtyp) von einer EGFR-Antikörpertherapie profitieren. Wichtige klinische Faktoren für die Auswahl des Chemotherapieregimes sind somit eine mögliche neoadjuvante Zielsetzung bei irresektablen Lebermetastasen, Tumorsymptome, die eine echte Tumorrückbildung notwendig machen, und bestehende Komorbiditäten des Patienten.
Literatur
1.
Zurück zum Zitat Simmonds PC (2000) Palliative chemotherapy for advanced colorectal cancer: systematic review and meta-analysis. Colorectal Cancer Collaborative Group. BMJ 321:531–535CrossRefPubMed Simmonds PC (2000) Palliative chemotherapy for advanced colorectal cancer: systematic review and meta-analysis. Colorectal Cancer Collaborative Group. BMJ 321:531–535CrossRefPubMed
2.
Zurück zum Zitat Van Cutsem E, Köhne CH, Hitre E et al (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417CrossRef Van Cutsem E, Köhne CH, Hitre E et al (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417CrossRef
3.
Zurück zum Zitat Saltz LB, Clarke S, Diaz-Rubio E et al (2008) Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 26:2013–2019CrossRefPubMed Saltz LB, Clarke S, Diaz-Rubio E et al (2008) Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 26:2013–2019CrossRefPubMed
4.
Zurück zum Zitat Kopetz S, Chang GJ, Overman MJ et al (2009) Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol 27:3677–3683CrossRefPubMed Kopetz S, Chang GJ, Overman MJ et al (2009) Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol 27:3677–3683CrossRefPubMed
5.
Zurück zum Zitat Adam R, Wicherts DA, de Haas RJ et al (2009) Patients with initially unresectable colorectal liver metastases: is there a possibility of cure? J Clin Oncol 27:1829–1835CrossRefPubMed Adam R, Wicherts DA, de Haas RJ et al (2009) Patients with initially unresectable colorectal liver metastases: is there a possibility of cure? J Clin Oncol 27:1829–1835CrossRefPubMed
6.
Zurück zum Zitat Are C, Gonen M, Zazzali K et al (2007) The impact of margins on outcome after hepatic resection for colorectal metastasis. Ann Surg 246:295–300CrossRefPubMed Are C, Gonen M, Zazzali K et al (2007) The impact of margins on outcome after hepatic resection for colorectal metastasis. Ann Surg 246:295–300CrossRefPubMed
7.
Zurück zum Zitat Chun YS, Laurent A, Maru D et al (2009) Management of chemotherapy-associated hepatotoxicity in colorectal liver metastases. Lancet Oncol 10:278–286CrossRefPubMed Chun YS, Laurent A, Maru D et al (2009) Management of chemotherapy-associated hepatotoxicity in colorectal liver metastases. Lancet Oncol 10:278–286CrossRefPubMed
8.
Zurück zum Zitat Jarnagin WR, Gonen M, Fong Y et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 236:397–406CrossRefPubMed Jarnagin WR, Gonen M, Fong Y et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 236:397–406CrossRefPubMed
9.
Zurück zum Zitat Jaeck D, Oussoultzoglou E, Rosso E et al (2004) A two-stage hepatectomy procedure combined with portal vein embolization to achieve curative resection for initially unresectable multiple and bilobar colorectal liver metastases. Ann Surg 240:1037–1049CrossRefPubMed Jaeck D, Oussoultzoglou E, Rosso E et al (2004) A two-stage hepatectomy procedure combined with portal vein embolization to achieve curative resection for initially unresectable multiple and bilobar colorectal liver metastases. Ann Surg 240:1037–1049CrossRefPubMed
10.
Zurück zum Zitat Ribero D, Abdalla EK, Madoff DC et al (2007) Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome. Br J Surg 94:1386–1394CrossRefPubMed Ribero D, Abdalla EK, Madoff DC et al (2007) Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome. Br J Surg 94:1386–1394CrossRefPubMed
11.
Zurück zum Zitat Fong Y, Fortner J, Sun RL et al (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230:309–318CrossRefPubMed Fong Y, Fortner J, Sun RL et al (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230:309–318CrossRefPubMed
12.
Zurück zum Zitat Reissfelder C, Rahbari NN, Koch M et al (2009) Validation of prognostic scoring systems for patients undergoing resection of colorectal cancer liver metastases. Ann Surg DOI 10.1245/s10434-009-0654-7 Reissfelder C, Rahbari NN, Koch M et al (2009) Validation of prognostic scoring systems for patients undergoing resection of colorectal cancer liver metastases. Ann Surg DOI 10.1245/s10434-009-0654-7
13.
Zurück zum Zitat Ruers T, van Coevorden F, Pierie J et al (2008) Radiofrequency ablation (RFA) combined with chemotherapy for unresectable colorectal liver metastases (CRC LM): Interim results of a randomised phase II study of the EORTC-NCRI CCSG-ALM Intergroup 40004 (CLOCC). J Clin Oncol (Meeting Abstracts) 26:4012 Ruers T, van Coevorden F, Pierie J et al (2008) Radiofrequency ablation (RFA) combined with chemotherapy for unresectable colorectal liver metastases (CRC LM): Interim results of a randomised phase II study of the EORTC-NCRI CCSG-ALM Intergroup 40004 (CLOCC). J Clin Oncol (Meeting Abstracts) 26:4012
14.
Zurück zum Zitat Ruers TJ, Wiering B, van dS Jr et al (2009) Improved selection of patients for hepatic surgery of colorectal liver metastases with (18)F-FDG PET: a randomized study. J Nucl Med 50:1036–1041CrossRefPubMed Ruers TJ, Wiering B, van dS Jr et al (2009) Improved selection of patients for hepatic surgery of colorectal liver metastases with (18)F-FDG PET: a randomized study. J Nucl Med 50:1036–1041CrossRefPubMed
15.
Zurück zum Zitat Mitry E, Fields AL, Bleiberg H et al (2008) Adjuvant chemotherapy after potentially curative resection of metastases from colorectal cancer: a pooled analysis of two randomized trials. J Clin Oncol 26:4906–4911CrossRefPubMed Mitry E, Fields AL, Bleiberg H et al (2008) Adjuvant chemotherapy after potentially curative resection of metastases from colorectal cancer: a pooled analysis of two randomized trials. J Clin Oncol 26:4906–4911CrossRefPubMed
16.
Zurück zum Zitat Nordlinger B, Sorbye H, Glimelius B et al (2008) Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet 371:1007–1016CrossRefPubMed Nordlinger B, Sorbye H, Glimelius B et al (2008) Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet 371:1007–1016CrossRefPubMed
17.
Zurück zum Zitat Saltz LB, Cox JV, Blanke C et al (2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 343:905–914CrossRefPubMed Saltz LB, Cox JV, Blanke C et al (2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 343:905–914CrossRefPubMed
18.
Zurück zum Zitat Douillard JY, Cunningham D, Roth AD et al (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355:1041–1047CrossRefPubMed Douillard JY, Cunningham D, Roth AD et al (2000) Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 355:1041–1047CrossRefPubMed
19.
Zurück zum Zitat Köhne CH, Van Cutsem E, Wils J et al (2005) Phase III study of weekly high-dose infusional 5-fluorouracil plus folinic acid with or without irinotecan in patients with metastatic colorectal cancer. EORTC Gastrointestinal Group Study 40986. J Clin Oncol 23:4856–4865CrossRefPubMed Köhne CH, Van Cutsem E, Wils J et al (2005) Phase III study of weekly high-dose infusional 5-fluorouracil plus folinic acid with or without irinotecan in patients with metastatic colorectal cancer. EORTC Gastrointestinal Group Study 40986. J Clin Oncol 23:4856–4865CrossRefPubMed
20.
Zurück zum Zitat de Gramont A, Figer A, Seymour M et al (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18:2938–2947 de Gramont A, Figer A, Seymour M et al (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18:2938–2947
21.
Zurück zum Zitat Giacchetti S, Perpoint B, Zidani R et al (2000) Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer. J Clin Oncol 18:136–147PubMed Giacchetti S, Perpoint B, Zidani R et al (2000) Phase III multicenter randomized trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first-line treatment of metastatic colorectal cancer. J Clin Oncol 18:136–147PubMed
22.
Zurück zum Zitat Tournigand C, Andre T, Achille E et al (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: A randomized GERCOR study. J Clin Oncol 22:229–237CrossRefPubMed Tournigand C, Andre T, Achille E et al (2004) FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: A randomized GERCOR study. J Clin Oncol 22:229–237CrossRefPubMed
23.
Zurück zum Zitat Arkenau HT, Arnold D, Cassidy J et al (2008) Efficacy of oxaliplatin plus capecitabine or infusional fluorouracil/leucovorin in patients with metastatic colorectal cancer: a pooled analysis of randomized trials. J Clin Oncol 26:5910–5917CrossRefPubMed Arkenau HT, Arnold D, Cassidy J et al (2008) Efficacy of oxaliplatin plus capecitabine or infusional fluorouracil/leucovorin in patients with metastatic colorectal cancer: a pooled analysis of randomized trials. J Clin Oncol 26:5910–5917CrossRefPubMed
24.
Zurück zum Zitat Reinacher-Schick AC, Kubicka S, Freier W et al (2008) Activity of the combination of bevacizumab (Bev) with capecitabine/irinotecan (CapIri/Bev) or capecitabine/oxaliplatin (CapOx/Bev) in advanced colorectal cancer (ACRC): A randomized phase II study of the AIO Colorectal Study Group (AIO trial 0604). J Clin Oncol (Meeting Abstracts) 26:4030 Reinacher-Schick AC, Kubicka S, Freier W et al (2008) Activity of the combination of bevacizumab (Bev) with capecitabine/irinotecan (CapIri/Bev) or capecitabine/oxaliplatin (CapOx/Bev) in advanced colorectal cancer (ACRC): A randomized phase II study of the AIO Colorectal Study Group (AIO trial 0604). J Clin Oncol (Meeting Abstracts) 26:4030
25.
Zurück zum Zitat Köhne CH, de Greve J, Hartmann JT et al (2008) Irinotecan combined with infusional 5-fluorouracil/folinic acid or capecitabine plus celecoxib or placebo in the first-line treatment of patients with metastatic colorectal cancer. EORTC study 40015. Ann Oncol 19:920–926CrossRefPubMed Köhne CH, de Greve J, Hartmann JT et al (2008) Irinotecan combined with infusional 5-fluorouracil/folinic acid or capecitabine plus celecoxib or placebo in the first-line treatment of patients with metastatic colorectal cancer. EORTC study 40015. Ann Oncol 19:920–926CrossRefPubMed
26.
Zurück zum Zitat Fuchs CS, Marshall J, Mitchell E et al (2007) Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in first-line treatment of metastatic colorectal cancer: results from the BICC-C Study. J Clin Oncol 25:4779–4786CrossRefPubMed Fuchs CS, Marshall J, Mitchell E et al (2007) Randomized, controlled trial of irinotecan plus infusional, bolus, or oral fluoropyrimidines in first-line treatment of metastatic colorectal cancer: results from the BICC-C Study. J Clin Oncol 25:4779–4786CrossRefPubMed
27.
Zurück zum Zitat Cunningham D, Humblet Y, Siena S et al (2004) Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 351:337–345CrossRefPubMed Cunningham D, Humblet Y, Siena S et al (2004) Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 351:337–345CrossRefPubMed
28.
Zurück zum Zitat Jonker DJ, O’Callaghan CJ, Karapetis CS et al (2007) Cetuximab for the treatment of colorectal cancer. N Engl J Med 357:2040–2048CrossRefPubMed Jonker DJ, O’Callaghan CJ, Karapetis CS et al (2007) Cetuximab for the treatment of colorectal cancer. N Engl J Med 357:2040–2048CrossRefPubMed
29.
Zurück zum Zitat Karapetis CS, Khambata-Ford S, Jonker DJ et al (2008) K-ras mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med 359:1757–1765CrossRefPubMed Karapetis CS, Khambata-Ford S, Jonker DJ et al (2008) K-ras mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med 359:1757–1765CrossRefPubMed
30.
Zurück zum Zitat Bokemeyer C, Bondarenko I, Makhson A et al (2009) Fluorouracil, leucovorin and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 27:663–671CrossRefPubMed Bokemeyer C, Bondarenko I, Makhson A et al (2009) Fluorouracil, leucovorin and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 27:663–671CrossRefPubMed
31.
Zurück zum Zitat Van Cutsem E, Lang I, D’Haens GR et al (2008) K-RAS status and efficacy in the CRYSTAL study: 1st-line treatment of patients with metastatic colorectal cancer (mCRC) receiving FOLFIRI with or without cetuximab. Ann Oncol 19:abstract 71O Van Cutsem E, Lang I, D’Haens GR et al (2008) K-RAS status and efficacy in the CRYSTAL study: 1st-line treatment of patients with metastatic colorectal cancer (mCRC) receiving FOLFIRI with or without cetuximab. Ann Oncol 19:abstract 71O
32.
Zurück zum Zitat Amado RG, Wolf M, Peeters M et al (2008) Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. J Clin Oncol 26:1626–1634CrossRefPubMed Amado RG, Wolf M, Peeters M et al (2008) Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer. J Clin Oncol 26:1626–1634CrossRefPubMed
33.
Zurück zum Zitat Douillard J-Y, Siena S, Cassidy J et al (2009) Randomized phase 3 study of panitumumab with FOLFOX4 compared to FOLFOX4 alone as 1st line treatment (tx) for metastatic colorectal cancer (mCRC): the PRIME trial. Eur J Cancer 7:abstract 10LBA Douillard J-Y, Siena S, Cassidy J et al (2009) Randomized phase 3 study of panitumumab with FOLFOX4 compared to FOLFOX4 alone as 1st line treatment (tx) for metastatic colorectal cancer (mCRC): the PRIME trial. Eur J Cancer 7:abstract 10LBA
34.
Zurück zum Zitat Di Nicolantonio F, Martini M, Molinari F et al (2008) Wild-type BRAF is required for response to panitumumab or cetuximab in metastatic colorectal cancer. J Clin Oncol 26:5705–5712CrossRef Di Nicolantonio F, Martini M, Molinari F et al (2008) Wild-type BRAF is required for response to panitumumab or cetuximab in metastatic colorectal cancer. J Clin Oncol 26:5705–5712CrossRef
35.
Zurück zum Zitat Jacobs B, De RW, Piessevaux H et al (2009) Amphiregulin and epiregulin mRNA expression in primary tumors predicts outcome in metastatic colorectal cancer treated with cetuximab. J Clin Oncol 27:5068–5074CrossRefPubMed Jacobs B, De RW, Piessevaux H et al (2009) Amphiregulin and epiregulin mRNA expression in primary tumors predicts outcome in metastatic colorectal cancer treated with cetuximab. J Clin Oncol 27:5068–5074CrossRefPubMed
36.
Zurück zum Zitat Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342CrossRefPubMed Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342CrossRefPubMed
37.
Zurück zum Zitat Kabbinavar FF, Hambleton J, Mass RD et al (2005) Combined analysis of efficacy: the addition of bevacizumab to fluorouracil/leucovorin improves survival for patients with metastatic colorectal cancer. J Clin Oncol 23:3706–3712CrossRefPubMed Kabbinavar FF, Hambleton J, Mass RD et al (2005) Combined analysis of efficacy: the addition of bevacizumab to fluorouracil/leucovorin improves survival for patients with metastatic colorectal cancer. J Clin Oncol 23:3706–3712CrossRefPubMed
38.
Zurück zum Zitat Giantonio B, Catalano PJ, Meropol NJ et al (2007) High-dose bevacizumab improves survival when combined with FOLFOX4 in previously treated advanced colorectal cancer: Results from the Eastern Cooperative Oncology Group (ECOG) study E3200. J Clin Oncol 25:1539–1544CrossRefPubMed Giantonio B, Catalano PJ, Meropol NJ et al (2007) High-dose bevacizumab improves survival when combined with FOLFOX4 in previously treated advanced colorectal cancer: Results from the Eastern Cooperative Oncology Group (ECOG) study E3200. J Clin Oncol 25:1539–1544CrossRefPubMed
39.
Zurück zum Zitat Chen HX, Mooney M, Boron M et al (2006) Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. J Clin Oncol 24:3354–3360CrossRefPubMed Chen HX, Mooney M, Boron M et al (2006) Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: an NCI Treatment Referral Center Trial TRC-0301. J Clin Oncol 24:3354–3360CrossRefPubMed
40.
Zurück zum Zitat Grothey A, Sugrue MM, Purdie DM et al (2008) Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: results from a large observational cohort study (BRiTE). J Clin Oncol 26:5326–5334CrossRefPubMed Grothey A, Sugrue MM, Purdie DM et al (2008) Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: results from a large observational cohort study (BRiTE). J Clin Oncol 26:5326–5334CrossRefPubMed
41.
Zurück zum Zitat Kopetz S, Abbruzzese JL (2009) Hidden biases in an observational study of bevacizumab beyond progression. J Clin Oncol 27:1732–1733CrossRefPubMed Kopetz S, Abbruzzese JL (2009) Hidden biases in an observational study of bevacizumab beyond progression. J Clin Oncol 27:1732–1733CrossRefPubMed
42.
Zurück zum Zitat Hecht JR, Mitchell E, Chidiac T et al (2009) A randomized phase IIIB trial of chemotherapy, bevacizumab, and panitumumab compared with chemotherapy and bevacizumab alone for metastatic colorectal cancer. J Clin Oncol 27:672–680CrossRefPubMed Hecht JR, Mitchell E, Chidiac T et al (2009) A randomized phase IIIB trial of chemotherapy, bevacizumab, and panitumumab compared with chemotherapy and bevacizumab alone for metastatic colorectal cancer. J Clin Oncol 27:672–680CrossRefPubMed
43.
Zurück zum Zitat Tol J, Koopman M, Cats A et al (2009) Chemotherapy, bevacizumab, and cetuximab in metastatic colorectal cancer. N Engl J Med 360:563–572CrossRefPubMed Tol J, Koopman M, Cats A et al (2009) Chemotherapy, bevacizumab, and cetuximab in metastatic colorectal cancer. N Engl J Med 360:563–572CrossRefPubMed
44.
Zurück zum Zitat Folprecht G, Grothey A, Alberts S et al (2005) Neoadjuvant treatment of unresectable colorectal liver metastases: correlation between tumour response and resection rates. Ann Oncol 16:1311–1319CrossRefPubMed Folprecht G, Grothey A, Alberts S et al (2005) Neoadjuvant treatment of unresectable colorectal liver metastases: correlation between tumour response and resection rates. Ann Oncol 16:1311–1319CrossRefPubMed
45.
Zurück zum Zitat Folprecht G, Gruenberger T, Bechstein WO et al (2009) Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. DOI 10.1016/S1470-2045(09)70330-4 Folprecht G, Gruenberger T, Bechstein WO et al (2009) Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. DOI 10.1016/S1470-2045(09)70330-4
46.
Zurück zum Zitat Falcone A, Ricci S, Brunetti I et al (2007) Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 25:1670–1676CrossRefPubMed Falcone A, Ricci S, Brunetti I et al (2007) Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 25:1670–1676CrossRefPubMed
47.
Zurück zum Zitat Saltz LB, Clarke S, az-Rubio E et al (2008) Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 26:2013–2019CrossRefPubMed Saltz LB, Clarke S, az-Rubio E et al (2008) Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 26:2013–2019CrossRefPubMed
48.
Zurück zum Zitat Karoui M, Penna C, Amin-Hashem M et al (2006) Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg 243:1–7CrossRefPubMed Karoui M, Penna C, Amin-Hashem M et al (2006) Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg 243:1–7CrossRefPubMed
49.
Zurück zum Zitat Seymour MT, Maughan TS, Ledermann JA et al (2007) Different strategies of sequential and combination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial. Lancet 370:143–152CrossRefPubMed Seymour MT, Maughan TS, Ledermann JA et al (2007) Different strategies of sequential and combination chemotherapy for patients with poor prognosis advanced colorectal cancer (MRC FOCUS): a randomised controlled trial. Lancet 370:143–152CrossRefPubMed
50.
Zurück zum Zitat Sargent DJ, Kohne CH, Sanoff HK et al (2009) Pooled safety and efficacy analysis examining the effect of performance status on outcomes in nine first-line treatment trials using individual data from patients with metastatic colorectal cancer. J Clin Oncol 27:1948–1955CrossRefPubMed Sargent DJ, Kohne CH, Sanoff HK et al (2009) Pooled safety and efficacy analysis examining the effect of performance status on outcomes in nine first-line treatment trials using individual data from patients with metastatic colorectal cancer. J Clin Oncol 27:1948–1955CrossRefPubMed
51.
Zurück zum Zitat Folprecht G, Seymour MT, Saltz L et al (2008) Irinotecan/fluorouracil combination in first-line therapy of older and younger patients with metastatic colorectal cancer: combined analysis of 2,691 patients in randomized controlled trials. J Clin Oncol 26:1443–1451CrossRefPubMed Folprecht G, Seymour MT, Saltz L et al (2008) Irinotecan/fluorouracil combination in first-line therapy of older and younger patients with metastatic colorectal cancer: combined analysis of 2,691 patients in randomized controlled trials. J Clin Oncol 26:1443–1451CrossRefPubMed
52.
Zurück zum Zitat Goldberg RM, Tabah-Fisch I, Bleiberg H et al (2006) Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly patients with colorectal cancer. J Clin Oncol 24:4085–4091CrossRefPubMed Goldberg RM, Tabah-Fisch I, Bleiberg H et al (2006) Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly patients with colorectal cancer. J Clin Oncol 24:4085–4091CrossRefPubMed
53.
Zurück zum Zitat Seymour MT, Maughan TS, Wasan HS et al (2007) Capecitabine (Cap) and oxaliplatin (Ox) in elderly and/or frail patients with metastatic colorectal cancer: The FOCUS2 trial. J Clin Oncol 25:abstract 9030CrossRef Seymour MT, Maughan TS, Wasan HS et al (2007) Capecitabine (Cap) and oxaliplatin (Ox) in elderly and/or frail patients with metastatic colorectal cancer: The FOCUS2 trial. J Clin Oncol 25:abstract 9030CrossRef
54.
Zurück zum Zitat Tournigand C, Cervantes A, Figer A et al (2006) OPTIMOX1: a randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-Go fashion in advanced colorectal cancer – a GERCOR study. J Clin Oncol 24:394–400CrossRefPubMed Tournigand C, Cervantes A, Figer A et al (2006) OPTIMOX1: a randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-Go fashion in advanced colorectal cancer – a GERCOR study. J Clin Oncol 24:394–400CrossRefPubMed
55.
Zurück zum Zitat Maindrault-Goebel F, Lledo G, Chibaudel B et al (2007) Final results of OPTIMOX2, a large randomized phase II study of maintenance therapy or chemotherapy-free intervals (CFI) after FOLFOX in patients with metastatic colorectal cancer (MRC): A GERCOR study. J Clin Oncol (Meeting Abstracts) 25:4013 Maindrault-Goebel F, Lledo G, Chibaudel B et al (2007) Final results of OPTIMOX2, a large randomized phase II study of maintenance therapy or chemotherapy-free intervals (CFI) after FOLFOX in patients with metastatic colorectal cancer (MRC): A GERCOR study. J Clin Oncol (Meeting Abstracts) 25:4013
56.
Zurück zum Zitat Adams R, Wilson R, Seymour MT et al (2009) Intermittent versus continuous oxaliplatin-based combination chemotherapy in patients with advanced colorectal cancer: a randomised non-inferiority trial (MRC COIN). Eur J Cancer 7:abstract 15LBA Adams R, Wilson R, Seymour MT et al (2009) Intermittent versus continuous oxaliplatin-based combination chemotherapy in patients with advanced colorectal cancer: a randomised non-inferiority trial (MRC COIN). Eur J Cancer 7:abstract 15LBA
57.
Zurück zum Zitat Van Cutsem E, Rougier P, Köhne CH et al (2009) A meta-analysis of the CRYSTAL and OPUS study combining Cetuximab with chemotherapy (CT) as 1th-line treatment for patients (pts) with metastatic colorectal cancer (mCRC): results according to KRAS and BRAF mutation status. Eur J Cancer 7 (Suppl):345 (abstract 6077) Van Cutsem E, Rougier P, Köhne CH et al (2009) A meta-analysis of the CRYSTAL and OPUS study combining Cetuximab with chemotherapy (CT) as 1th-line treatment for patients (pts) with metastatic colorectal cancer (mCRC): results according to KRAS and BRAF mutation status. Eur J Cancer 7 (Suppl):345 (abstract 6077)
58.
Zurück zum Zitat Bokemeyer C, Bondarenko I, Hartmann JT et al (2009) Overall survival of patients with KRAS wild-type tumors treated with FOLFOX4 ± cetuximab as 1 th-line treatment for metastatic colorectal cancer: The OPUS study. Eur J Cancer 7 (Suppl):345 (abstract 6079) Bokemeyer C, Bondarenko I, Hartmann JT et al (2009) Overall survival of patients with KRAS wild-type tumors treated with FOLFOX4 ± cetuximab as 1 th-line treatment for metastatic colorectal cancer: The OPUS study. Eur J Cancer 7 (Suppl):345 (abstract 6079)
Metadaten
Titel
Therapie des metastasierten Kolonkarzinoms
verfasst von
PD Dr. G. Folprecht
C. Bokemeyer
J. Weitz
Publikationsdatum
01.12.2009
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 12/2009
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-009-1723-z

Weitere Artikel der Ausgabe 12/2009

Die Onkologie 12/2009 Zur Ausgabe

In der Diskussion: Komplementäre Onkologie

Komplementäre Therapieverfahren in der Onkologie

CME Weiterbildung · Zertifizierte Fortbildung

Moderne molekulare Onkodiagnostik aus methodischer Sicht

Neu im Fachgebiet Onkologie

Verkürzte MRT bei dichtem Brustgewebe: Was bringen sequenzielle Scans?

21.07.2024 Mamma-MRT Nachrichten

Frauen mit dichtem Brustgewebe könnten zusätzlich zum regulären Mammografie-Screening von sequenziellen MRT-Untersuchungen mit verkürztem Protokoll (AB-MRT) profitieren, schlagen US-Radiologen vor.

Informierte Frauen neigen zu späterem Mammografie-Screening

Frauen in ihren 40ern, die über die Vor- und Nachteile des Mammografie-Screenings auf Brustkrebs informiert werden, neigen stärker dazu, den Screeningbeginn nach hinten zu verschieben. Die Mehrheit aber nähme das Angebot an, wie eine US-Studie zeigt.

Endometriose-Subtypen und das Risiko für Ovarialkarzinome

19.07.2024 Ovarialkarzinom Nachrichten

US-Kohortendaten sprechen dafür, dass verschiedene Endometrioseformen unterschiedlich mit dem Risiko für Ovarialkarzinome assoziiert sind. Besonders erhöht ist das Risiko offenbar bei tief infiltrierenden und ovariellen Endometrioseformen.

Die zelluläre Differenzierung wird wiederhergestellt

18.07.2024 Akute myeloische Leukämie Nachrichten

Ivosidenib von Servier ist ein Inhibitor der mutierten Isoform der Isocitrat-Dehydrogenase-1 (IDH1) und wird zur Behandlung von Patientinnen und Patienten mit neu diagnostizierter akuter myeloischer Leukämie (AML) eingesetzt. Die Substanz sorgt für die Wiederherstellung der zellulären Differenzierung.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.