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Update on Anti-angiogenesis Therapy in Colorectal Cancer
Open accessAbstract
Angiogenesis is a complex biologic process critical to growth and proliferation of colorectal cancer. The safety and efficacy of various anti-angiogenic agents have been investigated in many treatment settings. Bevacizumab, an anti-vascular endothelial growth factor agent, has efficacy in both the first-line setting and beyond progression in metastatic colorectal cancer. The decoy vascular endothelial growth factor receptor aflibercept has been approved in combination with 5-fluorouracil, leucovorin and irinotecan-based chemotherapy in metastatic colorectal cancer patients whose disease has progressed on a prior oxaliplatin-based chemotherapy regimen. The multikinase inhibitor regorafenib is modestly effective in the refractory colorectal cancer setting but confers significant toxicity. Ramucirumab, an anti-vascular endothelial growth factor receptor 2 molecule, has efficacy in combination with 5-fluorouracil, leucovorin and irinotecan after disease progression on a first-line bevacizumab-, oxaliplatin- and fluoropyrimidine-containing regimen. Questions regarding optimal treatment setting, predictive biomarkers of response, and cost effectiveness of these anti-angiogenic agents and others are as yet unanswered.
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Few clinical trials suggested an improved response rate with bevacizumab plus EGFR inhibitors, while others showed increased toxicity without significant survival benefit.
“However, few clinical trials suggested an improved response rate, while others showed increased toxicity without significant survival benefit.”
From Overcoming Resistance to Anti-EGFR Therapies: Mechanisms of Cetuximab and Panitumumab Resistance and Emerging Combination Strategies (2026) · cites this paper as [81]
The Bevacizumab section reports outcomes for bevacizumab with chemotherapy, including toxicity and survival, but does not address bevacizumab combined with EGFR inhibitors. Searches for EGFR inhibitors, cetuximab, and panitumumab did not locate a passage comparing the claimed response rates, toxicity, or survival for that combination. No page numbers were provided in our copy. (LLM, conf=0.72)
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Tabernero, J., Yoshino, T., Cohn, A. L., Obermannova, R., Bodoky, G., Garcia-Carbonero, R., Ciuleanu, T.-E., Portnoy, D. C., Van Cutsem, E., Grothey, A., et al. (2015) · The Lancet Oncology · doi:10.1016/s1470-2045(15)70127-0 · Cited by 952
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Henrykowska, G., Bartusik-Aebisher, D., Dynarowicz, K., Ramesh, T. S., Smolak, B., & Aebisher, D. (2026) · Pharmaceuticals · doi:10.3390/ph19071041 · Cited by 1
Metadata
- Authors
- Ciombor, K. K., & Goldberg, R. M.
- Affiliations
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- Corresponding author
- Goldberg, Richard M.
- Venue
- Current Colorectal Cancer Reports
- Published
- 2015-09-04
- Volume
- 11
- Issue
- 6
- Pages
- 378-387
- ISSN
- 1556-3790 (ISSN-L)
- 1556-3804
- PMC
- PMC4991548
- OpenAlex
- W2145988365
- Cited by
- 11
- References
- 2
- Citations by year
- 2026: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Colorectal Cancer Reports (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P30CA016086)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
- Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
- Keywords
- anti-angiogenic therapy, colorectal cancer, metastatic colorectal cancer, bevacizumab, aflibercept, regorafenib, ramucirumab, vascular endothelial growth factor, VEGFR2, multikinase inhibitor, 5-fluorouracil, irinotecan, oxaliplatin, predictive biomarkers, cost-effectiveness
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