There is a new hope for patients with colorectal cancers who have a relapse or metastasis after operations as their life may be extended by using targeted treatments and chemotherapy concomitantly.   A 60-year-old patient had an operation after being diagnosed with stage 2 colorectal cancer; however, the cancer cells spread to his lung one year after the operation.  He was then under the combination treatment of Angiogenesis Inhibitors and chemotherapy.  The result was quite satisfying.  His condition has been under control for over 18 months.

Colorectal cancer is the most deadly cancer in Taiwan for 7 years in a row.  Dr. Ke Jing-Liang of the Tri-Service General Hospital expressed that the early symptoms of colorectal cancer are not obvious; therefore, in many cases, cancer cells have already spread or transferred to other organs when the diagnosis is confirmed.  By then, the success rate of an operation is quite slim.  Hence, treatments mainly aim at prolonging patients’ life. 

30 years ago, chemotherapy was the only treatment available for metastatic colorectal cancer.  As technology advances, there are various combinations of targeted therapies and chemotherapies available for patients.  The average survival period has been extended from 5 months to 30 months.  Some patients even passed the 5-year landmark. 

At present, the targeted therapies reimbursed by the NHI are only for the first line and the third line treatment.  Patients can choose Angiogenesis Inhibitors or Epidermal Growth Factor Inhibitors for the first line treatment.  The NHI-reimbursed third line treatment is only available for patients who used Angiogenesis Inhibitors for their first line treatment.

As for the second line treatment, the MOHW has approved the continued treatment of Angiogenesis Inhibitors for the second line treatment.  Clinical data shows that the concomitant use of Angiogenesis Inhibitors and chemotherapy can reduce the death rate by 20% and extend the average progression-free time to almost 6 months. 

How should a patient choose between the two options for the first line treatment? Dr. Ke reckoned that Angiogenesis Inhibitors can be used in patients as a first line treatment no matter whether their cancer cells are mutated or not.  Its effect is similar to that of Epidermal Growth Factor Inhibitors.  Though the NHI does not reimburse Angiogenesis Inhibitors for second line treatment, patients with wild-type gene may qualify for NHI-reimbursed Angiogenesis Inhibitors for third line treatment if they have been using Angiogenesis Inhibitors all the way.  Patients should carefully consider their treatment strategy in order to increase their chance of survival.”

【2015-06-29/ UHO News】