NCCN Guidelines for Patients
Rectal Cancer, Version 1.2017
Targeted therapy is a class of drugs that stops the
action of molecules that help cancer cells grow. It is
less likely to harm normal cells than chemotherapy.
Targeted therapy for rectal cancer targets either the
actor) or EGFR
eceptor) pathway. Targeted
therapy used for rectal cancer is listed in
Targeted therapies are briefly described next. Some
side effects are listed. Ask your treatment team for
a full list of common and rare side effects. In Parts 4
through 6, information on who should receive these
drugs is provided.
Cancer cells need the food and oxygen in blood to
grow. Cancer cells get blood from blood vessels
that have grown into the tumor. VEGF is one of the
molecules that triggers the growth of these blood
VEGF is made by cancer cells. It travels from cancer
cells to endothelial cells. Endothelial cells form blood
Surface receptors are proteins within cell membranes
that extend from the inside to the outside of cells.
VEGF attaches to surface receptors on the outside
of endothelial cells. Attachment of VEGF to receptors
triggers growth signals. There are four medicines
used to stop the growth signals caused by VEGF.
Bevacizumab attaches to VEGF before it attaches to
receptors on endothelial cells.
See Figure 13
a result, VEGF can’t attach to receptors. No growth
signals caused by VEGF are started.
Bevacizumab is given by infusion. It takes about
90 minutes to get the first dose and 30 minutes
for later doses. Bevacizumab is always given with
chemotherapy. It is given every two or three weeks
depending on the chemotherapy.
Common side effects of bevacizumab are high blood
pressure, nosebleeds, and headache. You might
also have a runny nose, protein in the urine, and
rectal bleeding. Rare but serious side effects include
stroke, heart attack, blood clots, kidney damage,
holes in the gut, abnormal passage between body
parts, and bleeding. Very rarely, brain damage
Overview of cancer treatments
Guide 3. Targeted therapy
Generic (chemical) name
Brand name (sold as)