Optimum Use of Biologics and Role of Maintenance Therapy in Colon Cancer

The current standard of care for the treatment of metastatic colorectal cancer involves at least six different regimens, and with the advent of new therapies, including biologic therapies, patients are projected to live beyond an average of 2 years. Data suggest a synergy between the biologics, which are in their infancy in terms of utilization, and they are being tested in the adjuvant setting in stage II and stage III disease. Ongoing and future trials will determine how best to incorporate these medicines into combination chemotherapy and determine if these medicines (or others) will have a role in maintenance chemotherapy for patients with metastatic colon cancer. However, the concept of incorporating maintenance therapy for colon cancer is clearly not established. Maintenance therapy has a requirement for less toxicity than current front-line therapies, and over the coming years, new agents will become available that maintain response and improve quality of life. Clinical trials involving novel agents as maintenance therapy are needed.