Oncology (Williston Park). 2014 Feb;28(2):110-8.
The medical treatment of metastatic colorectal cancer (mCRC) has advanced significantly over the last 10 years as the result of the introduction of several active cytotoxic and biologic agents into standard clinical practice. Several recent phase III trials reported median overall survival data exceeding 30 months, an achievement inconceivable only 5 years ago.The first major step forward in the medical management of mCRC was provided by the addition of irinotecan and oxaliplatin to fluorouracil-based therapy; this increased survival from about 12 months to about 20 months.The introduction of biologic agents such as vascular endothelial growth factor inhibitors and epidermal growth factor inhibitors further increased survival--to more than 2 years in prospective trials. Recently, an expanding array of molecular prognostic and predictive biomarkers have been developed that are being integrated into clinical practice. In this review we discuss the current treatment options in metastatic colon cancer, with a special focus on biologic agents and how molecular understanding guides treatment decisions.
过去 10 年来，转移性结直肠癌（mCRC）的治疗取得了显著进展，这得益于几种有效的细胞毒性药物和生物制剂被引入标准临床实践。最近的几项 III 期临床试验报告了中位总生存期数据超过 30 个月，这在 5 年前是难以想象的。mCRC 医学管理的第一个重大进展是在氟尿嘧啶为基础的治疗中加入伊立替康和奥沙利铂；这将生存时间从大约 12 个月延长到了大约 20 个月。生物制剂如血管内皮生长因子抑制剂和表皮生长因子抑制剂的引入进一步提高了生存率——在前瞻性试验中超过 2 年。最近，大量新的分子预后和预测生物标志物已经被开发出来，并被整合到临床实践中。在这篇综述中，我们讨论了转移性结肠癌的当前治疗选择，特别关注生物制剂以及分子认识如何指导治疗决策。
