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结直肠癌肝转移患者的个体化治疗

Personalized treatment in patients with colorectal liver metastases.

作者信息

Moris Dimitrios, Pawlik Timothy M

机构信息

Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio.

Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, Ohio.

出版信息

J Surg Res. 2017 Aug;216:26-29. doi: 10.1016/j.jss.2017.04.013. Epub 2017 Apr 20.

Abstract

BACKGROUND

Precision Medicine Initiative is a new research effort aiming to offer personalized treatment in many diseases, including cancer. The aim of the present article is to offer novel insights about the role of personalized treatment in patients with colorectal liver metastases (CRLM).

METHODS

A review of the literature regarding personalized medicine and colorectal liver metastases was performed mainly in the MEDLINE/PubMed database.

RESULTS

Surgical resection remains the only hope for cure of CRLM. Improved surgical strategies to optimize remnant liver volume are recently introduced and gaining ground. Following resection of CRLM scoring systems have been developed by combining certain preoperative factors such as microsatellite instability KRAS expression and sensitivity to immunotherapy with Programmed Death-1 inhibitor.

CONCLUSIONS

Multidisciplinary management of patients with CRLM has markedly contributed to increased survival. While the last several decades have been characterized by these important developments, future advances for patients with CRLM will depend on a better understanding of genomics and molecular biology to facilitate characterization of a specific tumor "identity" so that individualized treatment for each CRLM patient becomes the rule, and not the exception.

摘要

背景

精准医学计划是一项新的研究工作,旨在为包括癌症在内的多种疾病提供个性化治疗。本文旨在提供关于个性化治疗在结直肠癌肝转移(CRLM)患者中作用的新见解。

方法

主要在MEDLINE/PubMed数据库中对有关精准医学和结直肠癌肝转移的文献进行综述。

结果

手术切除仍然是治愈CRLM的唯一希望。最近引入了优化残余肝体积的改进手术策略并逐渐得到认可。在CRLM切除术后,通过结合某些术前因素,如微卫星不稳定性、KRAS表达以及对程序性死亡-1抑制剂免疫疗法的敏感性,开发了评分系统。

结论

CRLM患者的多学科管理显著提高了生存率。尽管过去几十年有这些重要进展,但CRLM患者未来的进展将取决于对基因组学和分子生物学的更好理解,以促进特定肿瘤“特征”的表征,从而使每个CRLM患者的个体化治疗成为常规而非例外。

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