Curr. Treat. Options in Oncol. (2015) 16:18 DOI 10.1007/s11864-015-0333-9 Lower Gastrointestinal Cancers (AB Benson, Section Editor) Incorporating Anti-VEGF Pathway Therapy as a Continuum of Care in Metastatic Colorectal Cancer Konstantinos Papadimitriou, MD Christian Rolfo, MD, PhD Elien Dewaele, MD Mick Van De Wiel, MD Jan Van den Brande, MD Sevilay Altintas, MD, PhD Manon Huizing, MD, PhD Pol Specenier, MD, PhD Marc Peeters, MD, PhD * Address * Medical Oncology Department, University Hospital of Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium Email: marc.peeters@uza.be * Springer Science+Business Media New York 2015 This article is part of the Topical Collection on Lower Gastrointestinal Cancers Keywords Anti-VEGF therapy I Continuum of care I Metastatic colorectal cancer I mCRC I Review Opinion statement Metastatic cancer was previously treated with distinctive lines of chemotherapy regimens upon disease progression or toxicity, yet the choices of therapy are actually interrelated, with the selection of a first-line regimen in part determining the choices available for subsequent treatment. Lately the therapeutic approach based on separate lines of treat- ment, tends to be replaced from a perspective strategical approach, that of the “continuum of care”. This strategy targets to an improved overall survival, improved of quality of life and minimization of toxicity through upfront design of treatment selection and sequenc- ing, exposure to all available drugs and minimization of unnecessary treatment. Anti-VEGF treatment has a well-documented role in this approach. Bevacizumab should be included in upfront treatment regimens for all mCRC patients independently of RAS status, unless contraindicated. Upfront bevacizumab could be combined with all available regimens since the optimal choice of backbone chemotherapy is yet to be defined. In RAS wild-type