The last 5 to 10 years have seen unprecedented advances in the treatment of metastatic colorectal cancer (mCRC).
In the era when 5-fluorouracil (FU) was the sole active agent, overall survival in phase III trials was approximately 11 to
12 months. In the modern era, the average median survival duration has doubled, and patients routinely live longer than
two years. This increase has been mainly driven by the availability of new active agents. The majority of patients with
metastatic colorectal cancer (mCRC) cannot be cured, and the intent of therapy is palliative. A subset of patients with
the liver, and in select cases, the lung-limited disease can undergo resection of metastases with curative intent. Initial
(“conversion”) chemotherapy may increase the number of patients with metastases who are eligible for resection. Palliative
chemotherapy can relieve symptoms, improve the quality of life (QOL), and prolong survival.