The Pathways of Tomorrow: What Does the Future Hold for the Treatment of Colorectal Cancer?

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Introduction

The currently available therapies for colorectal cancer have led to a significant increase in survival, but the majority of patients with advanced disease progress and eventually die of their disease. This is a particularly frustrating scenario when a patient experiences a complete remission, only to recur with refractory disease.

One explanation is that that the currently available drugs—fluoropyrimidines, oxaliplatin (Eloxatin), irinotecan (CPT-11, Camptosar), bevacizumab (Avastin), cetuximab (Erbitux), and panitumumab (Vectibix)—target pathways necessary for growth of the majority of tumor cells, but do not address the tumor cells truly responsible for sustaining the malignant process. Recent evidence suggests that a subset of cells within a tumor have characteristics similar to stem cells. These cells have been termed tumor stem cells or tumor initiating cells.