Systemic therapy for advanced or metastatic colorectal cancer: National Comprehensive Cancer Network guidelines for combining anti-vascular endothelial growth factor and anti-epidermal growth factor receptor monoclonal antibodies with chemotherapy.

Abstract During the past decade, new therapies for colorectal cancer have emerged that significantly prolong survival times. The introduction of these new agents has resulted in changes in colorectal cancer treatment patterns; clinicians are now able to optimize therapy and minimize toxicity by developing individualized patient treatment plans using a variety of agents. Biologic agents, including bevacizumab, an anti-vascular endothelial growth factor (VEGF) monoclonal antibody, and cetuximab and panitumumab, anti-epidermal growth factor receptor (EGFR) monoclonal antibodies, are among the new therapies now recommended by the National Comprehensive Cancer Network (NCCN) colon and rectal cancer treatment guidelines for use in first-, second-, and/or third-line colorectal cancer therapy. According to the NCCN guidelines, patients with advanced or metastatic colorectal cancer who are without contraindications are candidates to receive the anti-VEGF and anti-EGFR monoclonal antibodies at some point during the treatment course.