Pabla Baldeep, Bissonnette Marc, Konda Vani J
Baldeep Pabla, Marc Bissonnette, Vani J Konda, Center of Endoscopic Research and Therapeutics, Section of Gastroenterology, Department of Medicine, Knapp Center for Biomedical Discovery, the University of Chicago Medicine, Chicago, IL 60637, United States.
World J Clin Oncol. 2015 Oct 10;6(5):133-41. doi: 10.5306/wjco.v6.i5.133.
Colorectal cancer represents the third most common and the second deadliest type of cancer for both men and women in the United States claiming over 50000 lives in 2014. The 5-year survival rate for patients diagnosed with metastatic colon and rectal cancer is < 15%. Early detection and more effective treatments are urgently needed to reduce morbidity and mortality of patients afflicted with this disease. Here we will review the risk factors and current treatment paradigms for colorectal cancer, with an emphasis on the role of chemoprevention as they relate to epidermal growth factor receptor (EGFR) blockade. We will discuss how various EGFR ligands are upregulated in the presence of Western diets high in saturated and N-6 polyunsaturated fats. We will also outline the various mechanisms of EGFR inhibition that are induced by naturally occurring chemopreventative agents such as ginseng, green tea, and curcumin. Finally, we will discuss the current role of targeted chemotherapy in colon cancer and outline the limitations of our current treatment options, describing mechanisms of resistance and escape.
在美国，结直肠癌是男性和女性中第三大常见且第二致命的癌症类型，2014年有超过50000人死于该病。被诊断为转移性结肠癌和直肠癌的患者5年生存率低于15%。迫切需要早期检测和更有效的治疗方法来降低患这种疾病患者的发病率和死亡率。在此，我们将回顾结直肠癌的风险因素和当前治疗模式，重点关注化学预防与表皮生长因子受体（EGFR）阻断相关的作用。我们将讨论在富含饱和脂肪和N-6多不饱和脂肪的西方饮食情况下，各种EGFR配体是如何上调的。我们还将概述由人参、绿茶和姜黄素等天然化学预防剂诱导的EGFR抑制的各种机制。最后，我们将讨论靶向化疗在结肠癌中的当前作用，并概述我们当前治疗选择的局限性，描述耐药性和逃逸机制。
