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Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2017; 23(26): 4675-4688
Published online Jul 14, 2017. doi: 10.3748/wjg.v23.i26.4675
Present and future of metastatic colorectal cancer treatment: A review of new candidate targets
Giulia Martini, Teresa Troiani, Claudia Cardone, Pietropaolo Vitiello, Vincenzo Sforza, Davide Ciardiello, Stefania Napolitano, Carminia Maria Della Corte, Floriana Morgillo, Antonio Raucci, Antonio Cuomo, Francesco Selvaggi, Fortunato Ciardiello, Erika Martinelli
Giulia Martini, Teresa Troiani, Claudia Cardone, Pietropaolo Vitiello, Vincenzo Sforza, Davide Ciardiello, Stefania Napolitano, Carminia Maria Della Corte, Floriana Morgillo, Fortunato Ciardiello, Erika Martinelli, Department of Internal and Experimental Medicine “F. Magrassi e A. Lanzara”, Institute of Medical Oncology, Università degli studi della Campania Luigi Vanvitelli, 80131 Naples, Italy
Antonio Raucci, Department of Internal and Experimental Medicine, Magrassi-Lanzara, Institute of Radiology, Università degli studi della Campania Luigi Vanvitelli, 80138 Naples, Italy
Antonio Cuomo, Gastroenterology Unit, Ospedale Umberto I, 84104 Nocera Inferiore, Italy
Francesco Selvaggi, Unit of Colorectal Surgery, Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences, Università degli studi della Campania Luigi Vanvitelli, 80138 Naples, Italy
Author contributions: Martini G performed the research and wrote the paper; Troiani T, Cardone C, Vitiello P, Sforza V, Ciardiello D, Napolitano S, Della Corte C, Morgillo F, Raucci A, Cuomo A, Selvaggi F, Ciardiello F and Martinelli E contributed to the critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: Authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Erika Martinelli, MD, PhD, Assistant Professor, Department of Internal and Experimental Medicine “F. Magrassi e A. Lanzara”, Institute of Medical Oncology, Università degli studi della Campania Luigi Vanvitelli, via Pansini 5, 80131 Naples, Italy. erika.martinelli@unina2.it
Telephone: +39-81-5666628 Fax: +39-81-5666732
Received: January 27, 2017
Peer-review started: February 6, 2017
First decision: March 16, 2017
Revised: April 21, 2017
Accepted: June 1, 2017
Article in press: June 1, 2017
Published online: July 14, 2017
Processing time: 165 Days and 7.8 Hours
Abstract

In the last two decades, great efforts have been made in the treatment of metastatic colorectal cancer (mCRC) due to the approval of new target agents for cytotoxic drugs. Unfortunately, a large percentage of patients present with metastasis at the time of diagnosis or relapse after a few months. The complex molecular heterogeneity of this disease is not completely understood; to date, there is a lack of predictive biomarkers that can be used to select subsets of patients who may respond to target drugs. Only the RAS-mutation status is used to predict resistance to anti-epidermal growth factor receptor agents in patients with mCRC. In this review, we describe approved targeted therapies for the management of metastatic mCRC and discuss new candidate targets on the horizon.

Keywords: Novel biomarkers; Monoclonal antibodies; Resistance; Mutation; RAS; Target therapy; Metastatic colorectal cancer

Core tip: Colorectal cancer is a heterogeneous disease characterized by several molecular alterations that affect genes implicated in cancer development. The discovery of novel biomarkers, together with a better understand of the complex biology of the disease, is essential to identify patients who will most likely benefit from personalized treatment.