Five chemotherapeutic regimens are recommended as initial therapies for patients with mCRC, with or without biologic therapy (VEGF or EGFR), including: FOLFOX, FOLFIRI, CAPEOX, infusional 5-FU/LV or capecitabine, and FOLFOXIRI. Although the specific regimens listed in the guidelines are designated according to whether they are appropriate as initial, secondary, or tertiary treatments, the recommendations represent a continuum of care, and these designations may be blurred. For example, an initial therapy may be chosen based on its potential toxicity in an individual patient, with subsequent therapies dependent on which was used as an initial therapy.
Important to know...
Sometimes "chemotherapy" and "systemic therapy" are used interchangeably. So when physicians refer to "chemotherapy" in the setting of mCRC, they may be referring to both chemotherapeutic and targeted agents, as these agents are considered together in the NCCN guidelines.
