Axel Grothey, MD, Professor of Oncology, Consultant, Medical Oncology, Mayo Clinic, discusses the novel agents being investigated for colorectal cancer (CRC). There has not been a new agent for CRC since the approval of cetuximab and bevacizumab 7 1/2 years ago.

Recently there have been numerous advances in what was previously a very stagnant field. One of the most important discoveries is that KRAS mutated tumors do not respond to epidermal growth factor receptor (EGFR) inhibitor drugs such as cetuximab and panitumumab.

Aflibercept, a novel agent currently under investigation, binds to the VEGF-A ligand, VEGF-B, and the placental growth factor (PIGF). Adding aflibercept to FOLFIRI in metastatic CRC patients resulted in significantly improved outcomes in the second-line setting.

The oral multikinase inhibitor named regorafenib demonstrated overall survival in heavily pretreated metastatic CRC; these patients currently do not have any clinical options. The data from the phase III trial, which was stopped early because of positive data, will be released at ASCO GI 2012.