University of Turin, Department of Oncology, Candiolo (TO), Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy.
University of Turin, Department of Oncology, Candiolo (TO), Italy; Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy.
Semin Cancer Biol. 2022 Sep;84:199-213. doi: 10.1016/j.semcancer.2021.04.007. Epub 2021 Apr 10.
Colorectal cancer (CRC) is one of the most common human malignancies accounting for approximately 10 % of worldwide cancer incidence and mortality. While early-stage CRC is mainly a preventable and curable disease, metastatic colorectal cancer (mCRC) remains an unmet clinical need. Moreover, about 25 % of CRC cases are diagnosed only at the metastatic stage. Despite the extensive molecular and functional knowledge on this disease, systemic therapy for mCRC still relies on traditional 5-fluorouracil (5-FU)-based chemotherapy regimens. On the other hand, targeted therapies and immunotherapy have shown effectiveness only in a limited subset of patients. For these reasons, there is a growing need to define the molecular and biological landscape of individual patients to implement novel, rationally driven, tailored therapies. In this review, we explore current and emerging approaches for CRC management such as genomic, transcriptomic and metabolomic analysis, the use of liquid biopsies and the implementation of patients' preclinical avatars. In particular, we discuss the contribution of each of these tools in elucidating patient specific features, with the aim of improving our ability in advancing the diagnosis and treatment of colorectal tumors.
结直肠癌（CRC）是最常见的人类恶性肿瘤之一，约占全球癌症发病率和死亡率的 10%。虽然早期 CRC 主要是一种可预防和可治愈的疾病，但转移性结直肠癌（mCRC）仍然是一个未满足的临床需求。此外，约 25%的 CRC 病例仅在转移阶段被诊断出来。尽管对这种疾病有广泛的分子和功能认识，但 mCRC 的系统治疗仍然依赖于传统的基于 5-氟尿嘧啶（5-FU）的化疗方案。另一方面，靶向治疗和免疫疗法仅在有限的一部分患者中显示出有效性。出于这些原因，越来越需要定义个体患者的分子和生物学特征，以实施新型、合理驱动、量身定制的治疗方法。在这篇综述中，我们探讨了当前和新兴的 CRC 管理方法，如基因组、转录组和代谢组分析、液体活检的应用以及患者临床前替身的实施。特别是，我们讨论了这些工具中的每一个在阐明患者特定特征方面的贡献，旨在提高我们在推进结直肠肿瘤诊断和治疗方面的能力。
