Targeted therapy in advanced metastatic colorectal cancer: current concepts and perspectives

World J Gastroenterol. 2014 May 28;20(20):6102-12. doi: 10.3748/wjg.v20.i20.6102.


The introduction of new cytotoxic substances as well as agents that target vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) signaling has improved clinical outcome of patients with metastatic colorectal cancer (mCRC). In this review we summarize the most relevant clinical data on VEGF and EGFR targeting regimens in mCRC. The effects of available treatment strategies for mCRC are often temporary, with resistance and disease progression developing in most patients. Thus, new treatment strategies are urgently needed. Some GI peptides including gastrin and gastrin releasing peptide, certain growth factors such as insulin-like growth factor-I and II and neuropeptides such as growth hormone releasing hormone (GHRH) are implicated in the growth of CRC. Experimental investigations in CRC with antagonistic analogs of bombesin/gastrin-releasing peptide, GHRH, and with cytotoxic peptides that can be targeted to peptide receptors on tumors, are summarized in the second part of the review.

Keywords: Colorectal cancer; Cytotoxic analogs; Epidermal growth factor receptor; Gastrin-releasing peptide; Growth hormone releasing hormone; Luteinizing hormone-releasing hormone; Peptide receptors; Targeted treatment; Vascular endothelial growth factor.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / metabolism
  • ErbB Receptors / metabolism*
  • Gene Expression Regulation, Neoplastic*
  • Gonadotropin-Releasing Hormone / metabolism
  • Humans
  • Molecular Targeted Therapy*
  • Neoplasm Metastasis
  • Peptide Fragments / chemistry
  • Peptides / chemistry
  • Receptors, Peptide / metabolism
  • Signal Transduction
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / metabolism*


  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Peptide Fragments
  • Peptides
  • Receptors, Peptide
  • Vascular Endothelial Growth Factor A
  • Gonadotropin-Releasing Hormone
  • ErbB Receptors