Existing anti-angiogenic therapeutic strategies for patients with metastatic colorectal cancer progressing following first-line bevacizumab-based therapy

Figure 1 Approved anti-vascular endothelial growth factor monoclonal antibodies in the treatment of metastatic colorectal cancer and their mechanisms of action. VEGF: Vascular endothelial growth factor; PIGF: Placental growth factor; FAK: Focal adhesion kinase; PI3K: Phosphoinositide 3-kinase; PLC-γ: Phospholipase C gamma; PKC: Protein kinase C; MAPK: Mitogen-activated protein kinases; Erk: Extracellular signal-regulated kinase.

Figure 2 A proposed algorithm for the management of patients with metastatic colorectal cancer after disease progression following bevacizumab-based first-line therapy. Rapid progressors: Patients progressing within 3 mo after starting first-line chemotherapy. ¹In patients who did not receive irinotecan-based first-line chemotherapy and only in combination with FOLFIRI. Pts: Patients; PD: Progressive disease; CT: Chemotherapy; BEV: Bevacizumab; wt: Wild-type; mt: Mutant; EGFR: Epidermal growth factor receptor.