Targeted therapies in colorectal cancer: the dos, don'ts, and future directions.

Abstract

2013 marks 10 years from the approval of the first targeted agent, bevacizumab, in colorectal cancer. Since the FDA approval of bevacizumab (Avastin®), we have seen the sequential approval of cetuximab (Erbitux®), panitumumab (Vectibix®), ziv-aflibercept (Zaltrap®), and regorafenib (Stivarga®). The approval of these angiogenesis and epidermal growth factor receptor (EGFR) targeting agents has been based on benefits in overall survival in metastatic colorectal cancer patients in the first, second, and chemotherapy-refractory settings. In this issue, we review the efficacy data behind the FDA approved targeted agents in colorectal cancer (1,2), their confirmed and suspected mechanisms of resistance (3,4), potential causes of failure in the adjuvant and neoadjuvant settings (5,6), special considerations in the surgical settings (7), and management of associated dermatological toxicities (8).