First Line Chemotherapy in Metastatic Colorectal Cancers: A Review

Colorectal cancer (CRC) is a common malignancy detected. Approximately, 22% of CRCs are metastatic at initial diagnosis, and about 70% of patients will eventually develop metastatic relapse. Metastatic colorectal cancer is a disease with poor prognosis whose treatment is always palliative chemotherapy. Today, thanks to the knowledge of molecular biology and the discoveries of new pathways, we have managed to increase survival to around 40 months which can increase thanks to the use of surgery and locoregional treatments. The choice of chemotherapy in these patients therefore depends on the characteristics of the molecular profile and includes, in fit patients, chemotherapy with the addition of targeted therapies. In this article, we examine the most recent data from randomized clinical trials supporting the use of chemotherapy triplets or doublets as well as the addition of bevacizumab or anti-epidermal growth factor receptor (EGFR) agents.