Taghizadeh Hossein, Prager Gerald W
Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
Comprehensive Cancer Center Vienna, Vienna, Austria.
Visc Med. 2020 Oct;36(5):397-406. doi: 10.1159/000508175. Epub 2020 Jun 29.
Colon cancer (CC) is one of the most frequent malignant diseases. Adjuvant chemotherapy is of utmost importance in the management of localized disease. With the emergence of precision medicine, treatment approaches are becoming increasingly personalized and complex. This review contributes to a broader understanding of the role and relevance of personalized adjuvant treatment strategies in colon carcinoma, and summarizes the current status in this disease entity.
We searched the websites ClinicalTrials.gov, PubMed, and ASCO (American Society of Medical Oncology) Meeting Library for clinical trials and retrospective analyses in the field of adjuvant treatment of CC with special attention to personalized approaches.
Various factors, including gender, age, sidedness, stage, dMMR/MSI-H, mutations, molecular profile, CMS, immunoscore, minimal residual disease, type of adjuvant therapy, therapy duration, and the patient's wish play an important role in the adjuvant setting of CC and should be considered in treatment decision making.
Future molecular profiling ideally assessed and monitored by liquid biopsy might personalize decision making even more in the adjuvant setting of CC patients. Further research and clinical trials are needed to clarify relevant questions and to highlight important clinical aspects.
结肠癌(CC)是最常见的恶性疾病之一。辅助化疗在局限性疾病的管理中至关重要。随着精准医学的出现,治疗方法正变得越来越个性化和复杂。本综述有助于更广泛地理解个性化辅助治疗策略在结肠癌中的作用和相关性,并总结该疾病实体的现状。
我们在ClinicalTrials.gov、PubMed和美国临床肿瘤学会(ASCO)会议图书馆网站上搜索了结肠癌辅助治疗领域的临床试验和回顾性分析,特别关注个性化方法。
多种因素,包括性别、年龄、肿瘤位置、分期、错配修复缺陷/微卫星高度不稳定(dMMR/MSI-H)、突变、分子谱、癌症分子分型(CMS)、免疫评分、微小残留病、辅助治疗类型、治疗持续时间以及患者意愿,在结肠癌的辅助治疗中起着重要作用,在治疗决策时应予以考虑。
未来通过液体活检进行理想评估和监测的分子谱分析可能会使结肠癌患者辅助治疗的决策更加个性化。需要进一步的研究和临床试验来阐明相关问题并突出重要的临床方面。