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Anti-angiogenic Agents in Resectable Colorectal Cancer Metastases: A Lebanese Experience

Antoine Abi Abboud, Evelyne Helou, Rim Ismail and Layale Olaywan

Background: Certain studies demonstrated that the addition of anti-VEGF and anti-EGFR drugs improves the overall survival, progression free survival, and response rate in colorectal cancer patients after resection of their liver metastases in a curative intent. We aimed to assess the benefit of addition of cetuximab to standard chemotherapy in patients with resectable colorectal liver metastases.

Methods: In this research, 11 patients with colorectal cancer and potentially curative liver metastases, who underwent metastasectomy from different Lebanese hospitals were analyzed. Patients received 5-FU, irinotecan, oxaliplatin with either cetuximab or bevacizumab pre and post operation. Response rate was compared between patients retrospectively, whether complete, partial, stable, or no response.

Results: Out of 11 patients, 5 patients had progression free survival for 3 months after surgery, out of which 1 (9%) had a complete response, 2 had partial response, and 2 had a stable disease. No increase in the major side effects or mortality was noted.

Discussion: Our results agree with other studies from different geographic regions. We recommend the addition of a biological agent to the standard systemic chemotherapy, because it is associated with improved overall survival and disease control rate, but further studies are still needed to investigate the influence of KRAS and BRAF mutation status on prognosis and treatment outcome.