Gmeiner William H
Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Onco Targets Ther. 2021 Mar 25;14:2121-2130. doi: 10.2147/OTT.S242224. eCollection 2021.
Metastatic colorectal cancer (mCRC) remains a highly lethal malignancy although considerable progress has resulted from characterizing molecular alterations such as mutation status and extent of microsatellite instability (MSI) to guide optimal use of available therapies. The availability of gene expression profiling, next generation sequencing technologies, proteomics analysis and other technologies provides high resolution information on individual tumors, including metastatic lesions to better define intra-tumor and inter-tumor heterogeneity. Recent literature applying this information to further customize personalized therapies is reviewed. Current biomarker-based stratification used to select optimal therapy that is personalized to the mutation profile of individual tumors is described. Recent literature using whole exome sequencing of metastatic lesions and primary CRC tumors and other advanced technologies to more fully elucidate the tumor biology specific to mCRC sub-types and to develop more precise therapies that improve outcomes is also reviewed.
转移性结直肠癌（mCRC）仍然是一种高度致命的恶性肿瘤，尽管在表征分子改变（如突变状态和微卫星不稳定性（MSI）程度）以指导现有疗法的最佳使用方面已经取得了相当大的进展。基因表达谱分析、下一代测序技术、蛋白质组学分析和其他技术的应用，为个体肿瘤（包括转移病灶）提供了高分辨率信息，以更好地定义肿瘤内和肿瘤间的异质性。本文综述了近期将这些信息应用于进一步定制个性化治疗的文献。描述了当前基于生物标志物的分层方法，该方法用于选择针对个体肿瘤突变谱的个性化最佳治疗方案。本文还综述了近期利用转移病灶和原发性结直肠癌肿瘤的全外显子测序及其他先进技术，更全面地阐明mCRC亚型特有的肿瘤生物学特性，并开发出能改善治疗效果的更精确疗法的文献。
