Given the high rate of distant spread, effective systemic therapy is key to improving survival in @entity1 with @entity14 ( @entity14 ). The past 40 years have seen progress. The addition of @entity4181 (FA) to @entity1487 ( @entity1487 ), the use of infusional rather than bolus @entity1487 , and the combination of new active agents such as @entity2600 and @entity901 with @entity1487 /FA have each led to an increase in activity. In trials of current combination regimens first-line, response rates (RRs) in excess of 50% and median survival durations longer than 16 months are seen. A recent controlled trial suggests that overall time to progression is maximized and @entity137 minimized when an @entity2600 / @entity1487 /FA combination is used first-line, followed by an @entity901 / @entity1487 /FA combination on progression. In the adjuvant setting, @entity1487 /FA is the standard of care in stage III disease but of uncertain value in stage II @entity1 . The role of new agents such as @entity2600 in adjuvant regimens is being assessed. Use of highly active chemotherapy in @entity1 with unresectable disease (particularly liver @entity3 ) achieves responses that allow a subset of @entity1 to proceed to potentially curative surgery. The emergence of novel agents targeted at processes such as @entity5 angiogenesis will complement cytotoxic chemotherapy, while improved understanding of @entity5 biology should enable agents to be selected according to the likely sensitivity of the disease in a particular @entity1 . In @entity356 also, surgery remains the only potentially curative treatment. The extent of dissection required is debated, as is the potential benefit of adjuvant chemoradiotherapy (indeed the degree of resection may interact with the effect of adjuvant treatment). In untreated metastatic @entity356 , median survival is 3-4 months. This can be increased to around 10 months using chemotherapy. Quality of life is also enhanced. There is no clearly defined standard of care. However, some form of @entity900 / @entity1487 combination can serve as a reference regimen. As single agents, both @entity2600 and @entity1205 achieve RRs of around 20% in metastatic @entity14 . In combination with @entity900 and/or @entity1487 a very high and promising RR is achieved. The promise of these agents in combination with @entity1487 and @entity1487 plus @entity900 is currently being tested in phase III trials.

Current treatments and future perspectives in XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4181 :: ('MESH:D002955', 'Chemical') :: ['folinic acid'] @entity901 :: ('MESH:C030110', 'Chemical') :: ['oxaliplatin'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity2600 :: ('MESH:C051890', 'Chemical') :: ['irinotecan'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity14 :: ('MESH:D015179', 'Disease') :: ['CRC', 'colorectal cancer'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity1205 :: ('MESH:C067311', 'Chemical') :: ['docetaxel'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric cancer'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-FU', '5-fluorouracil']
@entity14 :: (MESH:D015179,Disease) :: ['colorectal and gastric cancer']
