TY - JOUR
T1 - The timing of chemotherapy and surgery for the treatment of colorectal liver metastases
AU - Nordlinger, Bernard
AU - Vauthey, Jean Nicolas
AU - Poston, Graeme
AU - Benoist, Stephane
AU - Rougier, Philippe
AU - Cutsem, Eric Van
N1 - Funding Information:
Bernard Nordlinger is a member of the Speaker's Bureau for Merck Serono International SA. Jean-Nicolas Vauthey received research support from sanofi-aventis and funding to attend/present at conferences from sanofi-aventis and Roche Pharmaceuticals. Dr. Vauthey is also a member of the Speaker's Bureau for sanofi-aventis and Roche Pharmaceuticals. Graeme Poston has served as a paid consultant or been on the Advisory Board of Biocompatibles, Pfizer Inc., Merck Serono International SA, and sanofi-aventis. Stephane Benoist reports receiving funding to attend/present at conferences from Merck Serono International SA and Roche Pharmaceuticals. Philippe Rougier has received research support from Roche Pharmaceuticals. He also has served as a paid consultant or been on the Advisory Board of Amgen, Merck Serono International SA, Pfizer Inc., Roche Pharmaceuticals, sanofi-aventis, and Nestlé; and is a member of the Speaker's Bureau for Bayer HealthCare AG. Eric Van Cutsem received research funding from Amgen, Merck Serono International SA, Pfizer Inc., Roche Pharmaceuticals, and sanofi-aventis.
PY - 2010/10/1
Y1 - 2010/10/1
N2 - Combining surgery and chemotherapy in the treatment of patients with colorectal hepatic metastases is increasingly becoming the standard of care. However, controversy remains regarding the juxtapositioning of chemotherapy and surgery, the duration of chemotherapy, and particularly, the use of preoperative chemotherapy in the treatment of patients with initially resectable metastases. The arguments for and against the different approaches presented are based on the data published in the medical literature and on the data presented at the most recent major oncology meetings, coupled with the personal experience of the authors. For patients with liver metastases that are resectable at presentation, perioperative chemotherapy has become the standard treatment in many institutions, with the recommendation that surgery is performed after a maximum of 6 cycles of systemic therapy. In the case of patients with initially unresectable liver metastases receiving preoperative systemic therapy, patients should be carefully monitored and surgery performed as soon as the metastases become resectable. All patients should, where possible, be treated by a multidisciplinary team. Going forward, it needs to be established whether more intensive treatment (ie, perioperative versus postoperative systemic therapy) is merited for the treatment of patients with initially resectable disease, and what the precise contribution of new therapeutic agents in these settings is, based on new prospective randomized trial data.
AB - Combining surgery and chemotherapy in the treatment of patients with colorectal hepatic metastases is increasingly becoming the standard of care. However, controversy remains regarding the juxtapositioning of chemotherapy and surgery, the duration of chemotherapy, and particularly, the use of preoperative chemotherapy in the treatment of patients with initially resectable metastases. The arguments for and against the different approaches presented are based on the data published in the medical literature and on the data presented at the most recent major oncology meetings, coupled with the personal experience of the authors. For patients with liver metastases that are resectable at presentation, perioperative chemotherapy has become the standard treatment in many institutions, with the recommendation that surgery is performed after a maximum of 6 cycles of systemic therapy. In the case of patients with initially unresectable liver metastases receiving preoperative systemic therapy, patients should be carefully monitored and surgery performed as soon as the metastases become resectable. All patients should, where possible, be treated by a multidisciplinary team. Going forward, it needs to be established whether more intensive treatment (ie, perioperative versus postoperative systemic therapy) is merited for the treatment of patients with initially resectable disease, and what the precise contribution of new therapeutic agents in these settings is, based on new prospective randomized trial data.
KW - Bevacizumab
KW - Cetuximab
KW - FOLFIRI
KW - FOLFOX
KW - FOLFOXIRI
KW - Neoadjuvant chemotherapy
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U2 - 10.3816/CCC.2010.n.031
DO - 10.3816/CCC.2010.n.031
M3 - Review article
C2 - 20920992
AN - SCOPUS:77957818218
SN - 1533-0028
VL - 9
SP - 212
EP - 218
JO - Clinical colorectal cancer
JF - Clinical colorectal cancer
IS - 4
ER -