open access

Vol 71, No 5 (2021)
Review paper
Published online: 2021-10-13
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De-escalation of the systemic therapy in advanced colorectal cancer – justified clinical practice from the point of view of efficiency and safety

Aleksandra Grela-Wojewoda1, Renata Pacholczak-Madej12, Wojciech M. Wysocki345, Marek Ziobro1
DOI: 10.5603/NJO.2021.0055
·
Nowotwory. Journal of Oncology 2021;71(5):303-310.
Affiliations
  1. Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland
  2. Anatomy department, Jagiellonian University, Collegium Medicum, Krakow, Poland
  3. Department of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Krakow, Poland
  4. Chair of Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
  5. Scientific Editorial Office, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

open access

Vol 71, No 5 (2021)
Review article
Published online: 2021-10-13

Abstract

Colorectal cancer is one of the most frequent malignant tumours in Poland, making up the third cause of cancer deaths both in women and in men with regards to the frequency of occurrence. The therapy of patients with high-stage colorectal cancer is palliative and should be conducted in a continual manner until the disease progression or unacceptable toxicity of treatment. By definition, palliative care aims at prolongation of the period to the exacerbation of the disease and of the overall survival with simultaneous guarantee of appropriate quality of life to the patients. A long-term use of a multidrug chemotherapy is often connected with the presence of clinically significant toxicity, therefore, de-escalation of systemic treatment is currently the subject of numerous analyses. The studies evaluating the effect of maintenance therapy on patient survival, prove that this kind of treatment makes up a valuable option in the case of patients in whom a good clinical effect is maintained with a concurrent reduction of toxicity of treatment. Especially in the context of the ongoing SARS-CoV-2 pandemic, monotherapy or less aggressive therapy should be discussed with patients.

Abstract

Colorectal cancer is one of the most frequent malignant tumours in Poland, making up the third cause of cancer deaths both in women and in men with regards to the frequency of occurrence. The therapy of patients with high-stage colorectal cancer is palliative and should be conducted in a continual manner until the disease progression or unacceptable toxicity of treatment. By definition, palliative care aims at prolongation of the period to the exacerbation of the disease and of the overall survival with simultaneous guarantee of appropriate quality of life to the patients. A long-term use of a multidrug chemotherapy is often connected with the presence of clinically significant toxicity, therefore, de-escalation of systemic treatment is currently the subject of numerous analyses. The studies evaluating the effect of maintenance therapy on patient survival, prove that this kind of treatment makes up a valuable option in the case of patients in whom a good clinical effect is maintained with a concurrent reduction of toxicity of treatment. Especially in the context of the ongoing SARS-CoV-2 pandemic, monotherapy or less aggressive therapy should be discussed with patients.

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Keywords

advanced colorectal cancer; de-escalation therapy; cetuximab; panitumumab; bevacizumab

About this article
Title

De-escalation of the systemic therapy in advanced colorectal cancer – justified clinical practice from the point of view of efficiency and safety

Journal

Nowotwory. Journal of Oncology

Issue

Vol 71, No 5 (2021)

Article type

Review paper

Pages

303-310

Published online

2021-10-13

DOI

10.5603/NJO.2021.0055

Bibliographic record

Nowotwory. Journal of Oncology 2021;71(5):303-310.

Keywords

advanced colorectal cancer
de-escalation therapy
cetuximab
panitumumab
bevacizumab

Authors

Aleksandra Grela-Wojewoda
Renata Pacholczak-Madej
Wojciech M. Wysocki
Marek Ziobro

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