Advances in the treatment of metastatic colorectal carcinoma

Background. In most cases, metastatic colorectal cancer is incurable; however, the prognosis and survival of these patients have significantly improved in the last 6 years. A few years back, the only efficient drug for colorectal carcinoma, 5-fluoruracil, yielded the mean survival of 10 months, whereas today, the survival rates of 20 months or more may be obtained by using new cytostatics. In the last six years, five new drugs were registered for the treatment of metastatic colorectal cancer. These are three cytostatics (capecitabine, irinotecan, oxaliplatin) and two target drugs (cetuximab and bevacizumab). Conclusions. A combined treatment assures a better quality of life, and longer remissions and overall survival. The combination of cytostatics and target drugs improves particularly the mean survival rate, which may be longer than 30 months. These combinations of drugs used together with surgical treatment of lung and liver metastases may result in complete remission. An important research achievement of this year is the determination of KRAS mutations. The KRAS gene is the first biomarker that predicts how well patients will respond to certain combination of treatment.