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Adjuvant and palliative systemic treatment for colon cancer
Currently, treatment of advanced colorectal cancer (CRC) is based on multidisciplinary approaches. Systemic chemotherapy with fluoropyrimidines plays an important role in the adjuvant and neoadjuvant treatment of locally advanced CRC and is the cornerstone of treatment in the metastatic setting. Targeted therapies with monoclonal antibodies directing epidermal growth factor receptor and vascular endothelial growth factor significantly improve the treatment outcome for metastatic CRC (mCRC), but they play no role in adjuvant treatment. Nevertheless, despite significant advances in the treatment of mCRC, the disease will progress in the majority of patients and median overall survival with the current available treatment is only about 18–30 months. Efforts to overcome the limited efficacy of current treatments are ongoing, including evaluation of immunotherapeutic approaches and combination therapies with new biological agents. Current treatment standards and new developments in locally advanced and mCRC are reviewed with focus on systemic therapy.