Vemala Ramraj Nagendra Gupta, Katti Sanjeev Vasudev, Sirohi Bhawna, Manikandan Divya, Nandakumar Govind
Columbia Asia Referral Hospital, Yeshwanthpur, Bangalore, India.
Columbia Asia Hospital, Whitefield, Bangalore, Bengaluru, India.
Indian J Surg Oncol. 2021 Apr;12(Suppl 1):169-180. doi: 10.1007/s13193-021-01289-6. Epub 2021 Mar 16.
Colorectal cancers are the third most common cancers in the world. Management of both primary and metastatic colorectal cancers has evolved over the last couple of decades. Extensive research in molecular oncology has helped us understand and identify these complex intricacies in colorectal cancer biology and disease progression. These advances coupled with improved knowledge on various mutations have helped develop targeted chemotherapeutics and has allowed planning an effective treatment regimen in this era of immunotherapy with precision. The diverse chemotherapeutic and biological agents at our disposal can make decision making a very complex process. Molecular profile, including CIN, RAS, BRAF mutations, microsatellite instability, ctDNA, and consensus molecular subtypes, are some of the important factors which are to be considered while planning an individualized treatment regimen. This article summarizes the current status of molecular oncology in the management of colorectal cancer and should serve as a practical guide for the clinical team.
结直肠癌是全球第三大常见癌症。在过去几十年中,原发性和转移性结直肠癌的治疗方法不断发展。分子肿瘤学的广泛研究帮助我们理解和识别结直肠癌生物学和疾病进展中的这些复杂细节。这些进展加上对各种突变的深入了解,有助于开发靶向化疗药物,并能够在这个免疫治疗时代精确地制定有效的治疗方案。我们可使用的多种化疗和生物制剂会使决策成为一个非常复杂的过程。分子特征,包括染色体不稳定(CIN)、RAS、BRAF突变、微卫星不稳定性、循环肿瘤DNA(ctDNA)和共识分子亚型,是制定个体化治疗方案时需要考虑的一些重要因素。本文总结了结直肠癌治疗中分子肿瘤学的现状,应为临床团队提供实用指南。