Progress in systemic therapy of advanced colorectal cancer

Until the early 1990s the therapeutic options of systemic therapy for advanced colorectal cancer were limited to fluorouracil and produced rather disappointing results. The progress in the management of this disease has been very rapid during the last decade. The median duration of survival among patients with advanced colorectal cancer has almost doubled from 10-12 months to 18-20 months. This improvement has been achieved due to the introduction of several new cytotoxic agents as well as the entirely new category of treatment addressing molecular targets. Although some of these new therapeutic modalities are still experimental, they may herald a shift in the management of colorectal cancer in very near future. The incorporation of novel therapeutic options into standard care should be based on mature data from well-projected clinical trials. Physicians should be aware of new toxicity profiles of modern therapies as well as their financial consequences.