Colorectal cancer is one of the most common
neoplasms in Western Countries and ranks second as a cause of death due to
cancer. The overall mortality at 5 years is about 40%. Patients with resectable metastatic disease can be cured, but for those who cannot, treatment is purely palliative, and overall survival (OS) is from approximately 7 to 24 months. Infusional regimen with modulated 5Fluorouracil (
5FU) gives an objective response rate (RR) of up to 30-40%. The addition of
CPT11 or
oxaliplatin to
5FU improves RR, time to progression (
TTP) and OS with a stabilization of disease (SD) in 40-70% of cases and 20-40%, respectively. The concurrent utilization of selective biological agents as
growth factor receptors acting at a molecular level and influencing the processes of
tumor formation and growth, increases
tumor cell apoptosis and inhibits
tumor growth; as a result, the
tumor regresses or is inhibited, with consequently prolonged OS and
TTP. This paper examines the problem related to the treatment of metastatic
colorectal cancer with SD. Current doubts regarding the continuation of one treatment until
disease progression (PD) with a risk of toxicity, whether or not to use a less toxic "maintenance"
therapy after a fairly aggressive "induction"
therapy in "stabilized" responders, or whether to stop the treatment in the presence of a SD confirmed after at least two consecutive evaluations, are present.