Novel therapeutics in metastatic colorectal cancer: molecular insights and pharmacogenomic implications

ABSTRACT

Although the survival of metastatic colorectal cancer (mCRC) patients has improved five-fold over the last century, CRC remains a significant global health burden. Impressive strides have been made in identifying new regimens, employing maintenance strategies to limit treatment toxicities, and combining multidisciplinary approaches to achieve cure in oligometastatic disease. Attempts at personalized integration of targeted agents have been limited by the ability to identify molecularly enriched patient populations most likely to benefit. In this review, we discuss novel therapeutics and regimens recently approved and in development for mCRC. In addition, we discuss using older agents in novel combination and maintenance strategies, and highlight evidence for implementing pharmacogenomic data and non-invasive monitoring into the personalized management of mCRC patients.

KEYWORDS:

• Angiogenesis
• biomarker
• EGFR
• fluoropyrimidines
• immunotherapy
• metastatic colorectal cancer
• microsatellite instability
• pharmacogenetics
• RAF
• RAS

Financial & competing interests disclosure

The authors were supported by University of Southern California. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.