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Open Access 01-12-2015 | Review

Neoadjuvant and conversion treatment of patients with colorectal liver metastasis: the potential role of bevacizumab and other antiangiogenic agents

Authors: Pilar García-Alfonso, Ana Ferrer, Silvia Gil, Rosario Dueñas, María Teresa Pérez, Raquel Molina, Jaume Capdevila, María José Safont, Carmen Castañón, Juana María Cano, Ricardo Lara

Published in: Targeted Oncology | Issue 4/2015

Abstract

More than 50 % of patients with colorectal cancer develop liver metastases. Surgical resection is the only available treatment that improves survival in patients with colorectal liver metastases (CRLM). New antiangiogenic targeted therapies, such as bevacizumab, aflibercept, and regorafenib, in combination with neoadjuvant and conversion chemotherapy may lead to improved response rates in this population of patients and increase the proportion of patients eligible for surgical resection. The present review discusses the available data for antiangiogenic targeted agents in this setting. One of these therapies, bevacizumab, which targets the vascular endothelial growth factor (VEGF) has demonstrated good results in this setting. In patients with initially unresectable CRLM, the combination of 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) plus bevacizumab has led to high response and resection rates. This combination is also effective for patients with unresectable CRLM. Moreover, the addition of bevacizumab to chemotherapy in the neoadjuvant setting of liver metastasis has a higher impact on pathological response rate. This drug also has a manageable safety profile, and according to recent data, bevacizumab may protect against the sinusoidal dilation provoked in the liver by certain cytotoxic agents. In phase II trials, antiangiogenic therapy has demonstrated benefits in the presurgical treatment of CRLM and may represent a new treatment pathway for these patients.

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Title: Neoadjuvant and conversion treatment of patients with colorectal liver metastasis: the potential role of bevacizumab and other antiangiogenic agents
Authors: Pilar García-Alfonso
Ana Ferrer
Silvia Gil
Rosario Dueñas
María Teresa Pérez
Raquel Molina
Jaume Capdevila
María José Safont
Carmen Castañón
Juana María Cano
Ricardo Lara
Publication date: 01-12-2015
Publisher: Springer International Publishing
Published in: Targeted Oncology / Issue 4/2015
Print ISSN: 1776-2596
Electronic ISSN: 1776-260X
DOI: https://doi.org/10.1007/s11523-015-0362-0

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