University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA; Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA
University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA; Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA.
Oncologist. 2014 Jul;19(7):704-11. doi: 10.1634/theoncologist.2013-0471. Epub 2014 May 28.
The decision regarding adjuvant therapy for patients with stage II colon cancer remains a challenge. In contrast to stage III colon cancer, for which compelling clinical data support the use of adjuvant chemotherapy, the clinical benefit of systemic therapy in unselected patients with stage II disease is modest at best. Risk stratification based on clinicopathologic features and DNA mismatch repair status is commonly used in adjuvant therapy decisions, but these factors do not have a desired level of precision in identifying patients at high risk. Recently, gene expression platforms have been developed to further define risk and to assist in therapeutic decision making for patients with stage II disease. This review describes those platforms that are furthest along in clinical development, in an effort to place their potential clinical application in context.
对于 II 期结肠癌患者的辅助治疗决策仍然是一个挑战。与 III 期结肠癌不同，对于后者，有强有力的临床数据支持辅助化疗的应用，而对于 II 期疾病的未经选择的患者，系统治疗的临床获益充其量只是适度的。基于临床病理特征和 DNA 错配修复状态的风险分层在辅助治疗决策中常用，但这些因素在识别高危患者方面没有达到理想的精确性。最近，已经开发了基因表达平台来进一步确定风险，并协助 II 期疾病患者的治疗决策。本综述描述了在临床开发中走得最远的那些平台，以期将其潜在的临床应用置于适当的背景下。
