Hansen Torben Frøstrup, Qvortrup Camilla, Pfeiffer Per
Danish Colorectal Cancer Center South, Vejle University Hospital, 7100 Vejle, Denmark.
Institute of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark.
Cancers (Basel). 2021 Mar 1;13(5):1031. doi: 10.3390/cancers13051031.
Since the late 1990s, therapy for metastatic colorectal cancer (mCRC) has changed considerably, and the combination of doublet or triplet chemotherapy and a targeted agent are now routinely used. The targeting of angiogenesis, the development of new blood vessels, represents a key element in the overall treatment strategy. Since the approval in 2004 of the first anti-angiogenetic drug, multiple agents have been approved and others are currently under investigation. We present an overview of the recent literature on approved systemic treatment of mCRC, with a focus on anti-angiogenic drugs, and current treatment approaches, and elaborate on the future role of angiogenesis in colorectal cancer as seen from a clinical perspective. The treatment of mCRC, in general, has changed from "one strategy fits all" to a more personalized approach. This is, however, not entirely the case for anti-angiogenetic treatments, partly due to a lack of validated biomarkers. The anti-angiogenetic standard treatment at the present primarily includes monoclonal antibodies. The therapeutic field of angiogenesis, however, has received increased interest after the introduction of newer combinations. These approaches will likely change the current treatment strategy, once again, to the overall benefit of patients.
自20世纪90年代末以来，转移性结直肠癌（mCRC）的治疗发生了很大变化，目前常规使用双联或三联化疗与靶向药物联合治疗。针对血管生成（即新血管的形成）进行靶向治疗是整体治疗策略的关键要素。自2004年首款抗血管生成药物获批以来，多种药物已获批，其他药物目前正在研究中。我们概述了近期关于mCRC获批全身治疗的文献，重点关注抗血管生成药物和当前的治疗方法，并从临床角度阐述血管生成在结直肠癌未来的作用。总体而言，mCRC的治疗已从“一刀切”策略转变为更个性化的方法。然而，抗血管生成治疗并非完全如此，部分原因是缺乏经过验证的生物标志物。目前抗血管生成的标准治疗主要包括单克隆抗体。然而，在引入更新的联合治疗方法后，血管生成治疗领域受到了更多关注。这些方法可能会再次改变当前的治疗策略，从而给患者带来全面益处。
