Download Click to view presentation

Dr Francis Daniel, MB. ChB,
FFR-RCSI, FRCR.
Consultant in Clinical
Oncology
www.bowelcancerwest.org.uk
What is new in Colorectal
Cancer Oncology?
www.bowelcancerwest.org.uk
 Local
disease: Colon, Adjuvant
treatment.
 Local disease: Rectum, Pre-op RT.
 Metastatic disease: New
combinations, New agents.
 Cancer Drug Fund.
www.bowelcancerwest.org.uk
Adjuvant Treatment
(Colon&Rectum)
 Flurouracil:
5-10 %
 Capecitabine: 5-10%
 Combination Chemotherapy
(Oxaliplatin+Capecitabine): 15-20%
www.bowelcancerwest.org.uk
Pre operative RT for Rectal tumour
 Selection
is now refined (MRI
selective criteria)
 Short Course RT (Mainly for low
rectum requiring APR)
 Long course RT with chemo (Down
staging when margin is threatened)
www.bowelcancerwest.org.uk
Before
www.bowelcancerwest.org.uk
After
Before
www.bowelcancerwest.org.uk
After
Combination Chemotherapy for
advanced diseases
 Oxaliplatin
+ Capecitabine = 40%
Response rate.
 Irinotecan and Capecitabine = 40%
 Cetuximab added = extra 10%
 Bevacizumab added = extra 10%
www.bowelcancerwest.org.uk
Cancer Drug Funds
Bevacizumab and Cetuximab
www.bowelcancerwest.org.uk
Vascular Epidermal Growth
Receptor
 VEGFR1
and VEGFR2 are expressed
on the surface of blood endothelial
cells. There is evidence that VEGFR2
is the major mediator of endothelial
cell mitogenesis, survival and
microvascular permeability.
Bevacizumab block this receptors
www.bowelcancerwest.org.uk
Bevacizumab
www.bowelcancerwest.org.uk
Epidermal Growth Factor Receptor

The epidermal growth factor receptor
(EGFR) is one of the members of the
family of receptor tyrosine kinases, which
consist of an extracellular domain that can
bind ligands, a transmembrane domain
and an intracellular tyrosine kinase
domain. Cetuximab blocks binding of
ligands to EGFR, thereby inhibiting
receptor phosphorylation and downstream
events.
www.bowelcancerwest.org.uk
Cetuximab
www.bowelcancerwest.org.uk
Thank you for listening
Any questions?
www.bowelcancerwest.org.uk