Colorectal Cancer: New Treatments, Improved Prognosis
New drugs show promise, but more research needs to be done.
colorectal cancer remains one of the most deadly cancers in the U.S.,
researchers are making steady progress against this disease. New drugs allow people with
even the most advanced metastatic disease to live longer. Admittedly, there's
no cure, and the improvements -- which can add several months to a patient's
life -- may seem modest.
But for people living with advanced colorectal cancer -- and their loved ones -- small
improvements make a huge difference. And experts are confident that treatment
will keep getting better.
"I think the attitude has changed among doctors, especially when it
comes to metastatic colorectal cancer," says Paulo M. Hoff, MD, an
oncologist at the MD Andersen Cancer Center at the University of Texas in
Houston. "We used to have a pessimistic view. But now we're seeing more
patients with metastatic cancer responding to treatment. They are also
responding well for a longer time."
"We have more tools than ever before to treat colorectal cancer,"
says Leonard Saltz, MD, leader of the colorectal disease management team at
Memorial Sloan Kettering Cancer Center in New York. "What we're doing now
is learning how to use them most effectively."
A Turning Point in Treating Colorectal Cancer
For decades, medications for colorectal cancer were limited to two drugs,
5-fluorouracil and leucovorin. But in 1996, things began to change.
- In 1996, the FDA approved Camptosar (irinotecan) for people with metastatic
colorectal cancer that had recurred or spread beyond the colon. (Metastatic
means that the cancer has spread to other parts of the body.)
- In 2002, the FDA approved the use of Eloxatin (oxaliplatin) in combination
with 5-Fluorouracil and Leucovorin.
The new drugs improved survival to an extent. For example, one study
published in the New England Journal of Medicine in 2004 found that
adding Eloxatin to standard chemotherapy boosted survival among patients with
advanced disease by 11%.
Advances in Targeted Therapies for Colorectal Cancer
Next, in 2004, came targeted therapies. Avastin (bevacizumab) and Erbitux
(cetuximab) are monoclonal antibodies, a new generation of cancer drugs that
can specifically target cancer tumors.
The problem with traditional chemotherapy is that it can't be focused. The
drugs go through the body, affecting both cancerous cells and healthy cells
alike. Targeted therapies affect the specific mechanisms that allow cancer
cells to grow. As a result, they may have fewer side effects.