Table Info

Table 3.

FDA-approved medications for colon and rectal cancer consisting of both generic and brand names

FDA-approved individual drugs (CRC)	Mechanism of action
Ipilimumab	Prevent inhibition of T-cell mediated immune responses to tumors by binding CTLA-4
Bevacizumab (Mvasi)	Mvasi, a mAb, inactivates serum VEGF treating metastatic CRC
Pembrolizumab	Binds to PD-1 inhibiting its interaction with PD-L1 and PD-L2. Enhances anti-tumor immune response and tumor immune monitoring
Tucatinib	Inhibits HER-2 suppressing tumors by affecting cell proliferation and AKT and MAPK signaling
Ziv-aflibercept (Zaltrap)	Inhibits VEGF-A and PIGF to reduce vascular permeability and inhibit neovascularization. Delay vision loss and advancement of metastatic CRC
Irinotecan hydrochloride	Restricts DNA strands from elegating by attaching to the topoisomerase I-DNA complex and inhibiting its action, which causes fatal double-stranded splits in the DNA. Causes apoptosis as DNA damage is ineffectively repaired
Nivolumab	Restores tumor-specific T-cell response in patients. Binds to PD-1, avert PD-L1 and PD-L2 from blocking the action of T-cells
Ramucirumab	By binding to VEGFR2, it halts the ligands (VEGF-A, VEGF-C, and VEGF-D) from binding to it, blocking VEGF-stimulated receptor phosphorylation and the proliferation, permeability, and migration of human endothelial cells that are later caused by ligands
Cetuximab	Blocks the binding of EGF, which in turn prevents EGFR activation. It also binds selectively to the EGFR and phosphorylates and activates receptor-associated kinases (MAPK, PI3K/AKT, and JAK/STAT)
Regorafenib	At clinically attained concentrations it inhibits the function of VEGFR1, VEGFR2, VEGFR3, RET, PDGFR-alpha, PDGFR-beta, KIT, FGFR1, FGFR2, BRAFV600E, PTK5, TIE2, TrkA, RAF-1, BRAF, DDR2, SAPK2, Eph2A, and Abl
Panitumumab	Panitumumab binds primarily to EGFR and prevents ligands from binding to EGFR
Leucovorin calcium	By strengthening the bond between the active metabolite (5-FdUMP) and the enzyme thymidylate synthetase, leucovorin increases the action of fluorouracil

CTLA-4: cytotoxic T lymphocyte antigen-4; mAb: monoclonal antibody; PD-1: programmed death-1; PD-L1: PD-ligand-1; HER-2: human epidermal growth factor receptor-2; AKT: AKT serine/threonine kinase; MAPK: mitogen-activated protein kinase; VEGF-A: vascular endothelial growth factor-A; PIGF: placental growth factor; I-DNA: I-motif DNA; VEGFR2: VEGF receptor 2 ; EGF: epidermal growth factor; EGFR: EGF receptor; PI3K: phosphatidylinositol-4,5-bisphosphate 3-kinase; JAK: Janus kinase; STAT: signal transducer and activator of transcription; RET: Ret proto-oncogene; PDGFR-alpha: platelet derived growth factor receptor alpha; KIT: KIT proto-oncogene, receptor tyrosine kinase; FGFR1: fibroblast growth factor receptor 1; PTK5: protein tyrosine kinase 5; TIE2: tyrosine kinase with immunoglobulin like and EGF like domains 2; RAF-1: Raf-1 proto-oncogene, serine/threonine kinase; BRAF: B-Raf proto-oncogene, serine/threonine kinase; DDR2: discoidin domain receptor tyrosine kinase 2; SAPK2: sucrose non-fermenting-1-related protein kinase 2; Eph2A: ephrin type-A receptor 2; Abl: a gene; 5-FdUMP: 5-fluorodeoxyuridine monophosphate; BRAFV600E: B-Raf proto-oncogene; TrkA: tropomyosin receptor kinase A

Declarations

Acknowledgments

We are thankful to Department of Biotechnology, Jaypee Institute of Information Technology, Noida for necessary facilities.

Author contributions

KD, PKT, MP, and CKJ: Conceptualization. KD and PKT: Investigation, Writing—original draft. KD, PKT, and MP: Visualization. SK, CKJ, RK, and SV: Writing—review & editing, Supervision. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

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