Abstract
Metastatic colorectal cancer is the second leading cause of cancer-related death in the Western population. New therapies have been developed at a rapid pace in the past 15 years with six new agents being approved since 1996, with the most recent addition approved in August 2012. These new cytotoxic and biologic agents have increased median overall survival from 12 to 24 months. Over 50 experimental agents are currently in clinical trials with one expected to be approved by the US FDA in the next year. The overall 5-year survival in patients with liver-isolated metastasis has improved with more aggressive surgical approaches and new chemotherapy regimens. Elderly patients with a good performance status are increasingly being given chemotherapy for metastatic disease with recent studies showing them to benefit in a similar manner to younger patients from combinations of chemotherapy and biological agents with similar toxicities.
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