Chen Hengchi, Fu Qiang, Sun Kelin
Clinic of Oncology, Clinical Center Nis, Serbia.
J BUON. 2019 Nov-Dec;24(6):2245-2252.
Colorectal cancer (CRC) is the third most common cancer and the second cause of cancer-related deaths worldwide. Despite early diagnosis and treatment improvement, the majority of patients will still suffer from metastatic disease (mCRC), which has a poor prognosis. Molecular diversity of CRC requires personalized targeted approach for improving patient outcomes. Antiangiogenic agents proved to be beneficial in the continuum of mCRC treatment. For efficient epidermal growth factor receptor (EGFR) directed therapy, subtle molecular selection and better strategies to overcome resistance are needed. BRAF mutant and HER-2 positive mCRC will soon be provided with approved targeted treatments and check-point inhibitors demonstrated effectiveness in microsatellite instability (MSI) - high mCRC. Moreover, numeorous promising agents are entering clinical trial arena. This review summarizes actual and possible targets and current and promising agents for mCRC treatment. With broader accessibility of liquid biopsy we could track molecular evolution of CRC and target genetic alterations as they emerge.
结直肠癌（CRC）是全球第三大常见癌症，也是癌症相关死亡的第二大原因。尽管早期诊断和治疗有所改善，但大多数患者仍会罹患转移性疾病（mCRC），其预后较差。CRC的分子多样性需要个性化的靶向治疗方法来改善患者预后。抗血管生成药物在mCRC治疗的连续过程中被证明是有益的。为了进行有效的表皮生长因子受体（EGFR）导向治疗，需要精细的分子选择和更好的克服耐药性的策略。BRAF突变型和HER-2阳性mCRC很快将有获批的靶向治疗药物，并且检查点抑制剂在微卫星高度不稳定（MSI）的mCRC中显示出有效性。此外，许多有前景的药物正在进入临床试验阶段。本综述总结了mCRC治疗的实际和可能的靶点以及当前和有前景的药物。随着液体活检的更广泛应用，我们可以追踪CRC的分子演变，并在基因改变出现时对其进行靶向治疗。
