John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Top-down strategies in non resectable metastatic colorectal cancers Volume 26, issue 6, Juin 2019

Authors
1 Centre Hospitalier Régional La Source, Service d’hépato-gastroentérologie et oncologie digestive, 14 avenue de l’Hôpital, BP 86709, F 45709 Orléans cedex2
2 CHU de Dijon, Université Bourgogne Franche-Comté, INSERM LNC UMR1231, 21000 Dijon
* Correspondance

Surgery seems to be the best treatment in the top-down approach, when after this invasive time, the chemotherapy can be stopped. Given the medical and surgical advances, the number of eligible patients is gradually increasing. The new drugs and associations have been studied without a multi-line strategic perspective. Their efficacy on overall survival, more relevant than the progression free survival in this perspective, is reminded in these prior studies. The best sequences of their successive use are described within a few phase III studies. The anatomic and biologic nature of the primitive tumor has an increasing role in the therapeutic choices. The maintenance treatments seem to be more effective than complete pauses of treatment but at the time of target therapies, a comparison of their use versus a fluoropyrymidine monotherapy is still needed.

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