The treatment of metastatic colorectal cancer has evolved significantly in recent years. Overall survival was significantly increased through the use of irinotecan and oxaliplatin, in combination with 5FU and leucovorin. More recently, new drugs directed against angiogenic factors or against an intracellular signaling pathway have demonstrated their effectiveness: bevacizumab (VEGF inhibitor) and cetuximab or panitumumab (inhibitors of EGF receptor) are the first molecules whose effect has been demonstrated in advanced colorectal cancer. Undoubtedly, advances in biology can both identify new targets, and therefore new treatments, but also better define patient groups most likely to get a benefit of these treatments.