Nandikolla Amara G, Rajdev Lakshmi
Department of Medical Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Transl Gastroenterol Hepatol. 2016 Sep 6;1:67. doi: 10.21037/tgh.2016.08.04. eCollection 2016.
Colorectal cancer (CRC) is one of the few cancers where screening modalities are standardized, but it still remains the third leading cause of cancer related mortality. For more than a decade now, the approval of anti-angiogenic therapy has led to an increase in the rate of overall survival (OS) of patients with advanced colon cancer. The drawback of the anti-angiogenic therapy is that their effect is short-lived and many patients progress through these therapies. Various mechanisms of resistance have been hypothesized, but overcoming this has been challenging. Also, there are no standardized predictive biomarkers that could aid in selecting patients who responds to the therapy upfront. This review focuses on the basis of angiogenesis, describing the approved anti-angiogenic therapies, discusses the challenges in terms of resistance to anti-angiogenic therapy and also the role of biomarkers. In the future, hopefully newer targeted therapies, immunotherapy, combination therapies and the standardization of biomarkers may result in improved outcomes and cure rates.
结直肠癌（CRC）是少数筛查方式已标准化的癌症之一，但它仍是癌症相关死亡的第三大主要原因。十多年来，抗血管生成疗法的获批提高了晚期结肠癌患者的总生存率（OS）。抗血管生成疗法的缺点是其效果短暂，许多患者会在这些疗法中病情进展。人们已经提出了各种耐药机制，但克服这一问题一直具有挑战性。此外，目前还没有标准化的预测生物标志物可用于预先选择对该疗法有反应的患者。本综述聚焦于血管生成的基础，描述已获批的抗血管生成疗法，讨论抗血管生成疗法耐药方面的挑战以及生物标志物的作用。未来，有望出现更新的靶向疗法、免疫疗法、联合疗法以及生物标志物的标准化，从而改善治疗结果和治愈率。
