Adaptation of international guidelines for metastatic colorectal cancer: an asian consensus.

Abstract

Colorectal cancer (CRC) is among the most common cancers worldwide, but marked epidemiological differences exist between Asian and non-Asian populations. Hence, a consensus meeting was held in Hong Kong in December 2012 to develop Asia-specific guidelines for the management of metastatic CRC (mCRC). A multidisciplinary expert panel, consisting of 23 participants from 10 Asian and 2 European countries, discussed current guidelines for colon or rectal cancer and developed recommendations for adapting these guidelines to Asian clinical practice. Participants agreed that mCRC management in Asia largely follows international guidelines, but they proposed a number of recommendations based on regional 'real-world' experience. In general, participants agreed that 5-fluorouracil (5-FU) infusion regimens in doublets can be substituted with UFT (capecitabine, tegafur-uracil) and S1 (tegafur, 5-chloro-2,4-dihydroxypyridine and oxonic acid), and that the monoclonal antibodies cetuximab and panitumumab are recommended for KRAS wild type tumors. For KRAS mutant tumors, bevacizumab is the preferred biological therapy. FOLFOX (folinic acid, 5-FU, and oxaliplatin) is preferred for initial therapy in Asian patients. The management of mCRC is evolving, and it must be emphasized that the recommendations presented here reflect current treatment practices and thus might change as more data become available.

• Authors: Ann-Lii Cheng, Jin Li, Ashok K Vaid, Brigette Buig Yue Ma, Catherine Teh, Joong B Ahn, Maximino Bello, Chaiyut Charoentum, Li-Tzong Chen, Gilberto de Lima Lopes Jr, Gwo F Ho, Hwai L Kong, Ka O Lam, Tian S Liu, Young S Park, Virote Sriuranpong, Aru W Sudoyo, Jaw-Yuan Wang, Jun Zhang, Su Z Zhang, Fortunato Ciardiello, Clause-Henning Köhne, Michael Shaw, Tae Won Kim
• Journal: Clinical colorectal cancer (Clin Colorectal Cancer) Vol. 13 Issue 3 Pg. 145-55 (Sep 2014) ISSN: 1938-0674 [Electronic] United States
• PMID: 25209093 (Publication Type: Consensus Development Conference, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Drug Combinations
• KRAS protein, human
• Organoplatinum Compounds
• Oxaloacetates
• Proto-Oncogene Proteins
• Deoxycytidine
• S 1 (combination)
• Tegafur
• Bevacizumab
• Oxonic Acid
• Capecitabine
• Panitumumab
• ErbB Receptors
• Proto-Oncogene Proteins p21(ras)
• ras Proteins
• Cetuximab
• Leucovorin
• Fluorouracil
• Camptothecin

Topics

• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Asia
• Bevacizumab
• Camptothecin (administration & dosage, analogs & derivatives)
• Capecitabine
• Cetuximab
• Colonic Neoplasms (genetics, pathology, therapy)
• Combined Modality Therapy
• Deoxycytidine (analogs & derivatives, therapeutic use)
• Drug Combinations
• ErbB Receptors (antagonists & inhibitors)
• Fluorouracil (administration & dosage, analogs & derivatives, therapeutic use)
• Guideline Adherence
• Humans
• Leucovorin (administration & dosage)
• Liver Neoplasms (genetics, secondary, therapy)
• Lung Neoplasms (genetics, secondary, therapy)
• Magnetic Resonance Imaging
• Metastasectomy
• Neoplasm Staging
• Organoplatinum Compounds (administration & dosage)
• Oxaloacetates
• Oxonic Acid (administration & dosage)
• Panitumumab
• Practice Guidelines as Topic
• Proto-Oncogene Proteins (genetics)
• Proto-Oncogene Proteins p21(ras)
• Rectal Neoplasms (genetics, pathology, therapy)
• Tegafur (administration & dosage)
• Tomography, X-Ray Computed
• ras Proteins (genetics)