Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Radiol Oncol. 2020 May 28;54(3):272-277. doi: 10.2478/raon-2020-0031.
Background Colorectal cancer (CRC) is one of the most common types of cancer in the world. Metastatic disease is still incurable in most of these patients, but the survival rate has improved by treatment with novel systemic chemotherapy and targeted therapy in combination with surgery. New knowledge of its complex heterogeneity in terms of genetics, epigenetics, transcriptomics and microenvironment, including prognostic and clinical characteristics, led to its classification into various molecular subtypes of metastatic CRC, called consensus molecular subtypes (CMS). The CMS classification thus enables the medical oncologists to adjust the treatment from case to case. They can determine which type of systemic chemotherapy or targeted therapy is best suited to a specific patient, what dosages are needed and in what order. Conclusions CMS in metastatic CRC are the new tool to include the knowledge of molecular factors, tumour stroma and signalling pathways for personalized, patient-orientated systemic treatment in precision medicine.
背景 结直肠癌（CRC）是世界上最常见的癌症类型之一。在大多数此类患者中，转移性疾病仍然无法治愈，但通过新型全身化疗和靶向治疗与手术相结合的治疗，其生存率得到了提高。在遗传学、表观遗传学、转录组学和微环境方面，包括预后和临床特征方面，对其复杂异质性的新认识导致其分类为转移性 CRC 的各种分子亚型，称为共识分子亚型（CMS）。因此，CMS 分类使肿瘤内科医生能够根据具体情况调整治疗方法。他们可以确定哪种类型的全身化疗或靶向治疗最适合特定患者，需要多少剂量以及以何种顺序进行。 结论 转移性 CRC 的 CMS 是新的工具，可将分子因素、肿瘤基质和信号通路的知识纳入精准医学中，为个体化、以患者为中心的全身治疗提供依据。
