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Targeted therapy in rectal cancer.

Publication ,  Journal Article
Willett, CG; Duda, DG; Czito, BG; Bendell, JC; Clark, JW; Jain, RK
Published in: Oncology (Williston Park)
August 2007

Epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) are often overexpressed in colorectal cancer and are associated with inferior outcomes. Based on successful randomized phase III trials, anti-EGFR and anti-VEGF therapeutics have entered clinical practice. Cetuximab (Erbitux), an EGFR-specific antibody, is currently approved in the United States in combination with irinotecan (Camptosar) for patients with metastatic colorectal cancer refractory to irinotecan or as a single agent for patients unable to tolerate irinotecan-based therapy. In retrospective analyses, patients with EGFR-expressing rectal cancer undergoing neoadjuvant radiation therapy had a significantly inferior disease-free survival and lower rates of achieving pathologic complete response. Based on the positive data in metastatic colorectal cancer and synergy with radiation therapy seen in preclinical models, there is a strong rationale to combine cetuximab with neoadjuvant radiation therapy and chemotherapy in rectal cancer. Bevacizumab (Avastin), a VEGF-specific antibody, was the first antiangiogenic agent to be approved in the United States for use in combination with standard chemotherapy in the first- and second-line of treatment in metastatic colorectal cancer. VEGF-targeted therapy may lead to indirect killing of cancer cells by damaging tumor blood vessels, and may increase the radiosensitivity of tumor-associated endothelial cells. VEGF blockade can also "normalize" tumor vasculature, thereby leading to greater tumor oxygenation and drug penetration. This review will address completed and ongoing trials that have established and continue to clarify the effects of these agents in rectal cancer.

Duke Scholars

Published In

Oncology (Williston Park)

ISSN

0890-9091

Publication Date

August 2007

Volume

21

Issue

9

Start / End Page

1055 / 1065

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • Rectal Neoplasms
  • Quinazolines
  • Neoadjuvant Therapy
  • Irinotecan
  • Humans
  • Gefitinib
  • Erlotinib Hydrochloride
  • Epidermal Growth Factor
  • Drug Delivery Systems
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Willett, C. G., Duda, D. G., Czito, B. G., Bendell, J. C., Clark, J. W., & Jain, R. K. (2007). Targeted therapy in rectal cancer. Oncology (Williston Park), 21(9), 1055–1065.
Willett, Christopher G., Dan G. Duda, Brian G. Czito, Johanna C. Bendell, Jeffrey W. Clark, and Rakesh K. Jain. “Targeted therapy in rectal cancer.Oncology (Williston Park) 21, no. 9 (August 2007): 1055–65.
Willett CG, Duda DG, Czito BG, Bendell JC, Clark JW, Jain RK. Targeted therapy in rectal cancer. Oncology (Williston Park). 2007 Aug;21(9):1055–65.
Willett, Christopher G., et al. “Targeted therapy in rectal cancer.Oncology (Williston Park), vol. 21, no. 9, Aug. 2007, pp. 1055–65.
Willett CG, Duda DG, Czito BG, Bendell JC, Clark JW, Jain RK. Targeted therapy in rectal cancer. Oncology (Williston Park). 2007 Aug;21(9):1055–1065.

Published In

Oncology (Williston Park)

ISSN

0890-9091

Publication Date

August 2007

Volume

21

Issue

9

Start / End Page

1055 / 1065

Location

United States

Related Subject Headings

  • Vascular Endothelial Growth Factor A
  • Rectal Neoplasms
  • Quinazolines
  • Neoadjuvant Therapy
  • Irinotecan
  • Humans
  • Gefitinib
  • Erlotinib Hydrochloride
  • Epidermal Growth Factor
  • Drug Delivery Systems