Kim Jae Hyun, Park Seun Ja
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Korean J Gastroenterol. 2016 Dec 25;68(6):303-311. doi: 10.4166/kjg.2016.68.6.303.
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Korea. Despite recent developments in the treatment of CRC, the median overall survival time in patients with metastatic CRC is less than 30 months. The biologic agents that target the epidermal growth factor receptor (EGFR) or vascular endothelial growth factor (VEGF) have proven clinical benefits in the treatment of patient with metastatic CRC. Anti-EGFR agents, including cetuximab and panitumumab, as well as anti-VEGF agents, including bevacizumab, aflibercept, ramucirumab, and regorafenib have been shown to extend survival in combination with cytotoxic chemotherapy. In particular, the addition of anti-EGFR agents has demonstrated significant efficacy in patients with the RAS wild-type metastatic CRC. In the future, building a personalized treatment strategy, according to the clinical characteristics and biologic features of patients with unresectable or metastatic CRC, will be necessary. In this review, we summarized the mechanisms of target therapy, the results of main clinical trials, and the guideline of clinical practice in patients with unresectable or metastatic CRC.
结直肠癌（CRC）是韩国第三大常见诊断癌症。尽管近期CRC治疗有进展，但转移性CRC患者的中位总生存时间仍不足30个月。靶向表皮生长因子受体（EGFR）或血管内皮生长因子（VEGF）的生物制剂已被证明在转移性CRC患者治疗中具有临床益处。抗EGFR药物，包括西妥昔单抗和帕尼单抗，以及抗VEGF药物，包括贝伐单抗、阿柏西普、雷莫西尤单抗和瑞戈非尼，已显示与细胞毒性化疗联合使用可延长生存期。特别是，添加抗EGFR药物已在RAS野生型转移性CRC患者中显示出显著疗效。未来，根据不可切除或转移性CRC患者的临床特征和生物学特性制定个性化治疗策略将很有必要。在本综述中，我们总结了不可切除或转移性CRC患者的靶向治疗机制、主要临床试验结果及临床实践指南。
