Kim Chang Hyun
Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Korea.
J Anus Rectum Colon. 2022 Oct 27;6(4):197-202. doi: 10.23922/jarc.2022-045. eCollection 2022.
Despite a trend showing continued improvement in survival by combing targeted agents in colorectal cancer, the improvement was limited, and clinically meaningful benefits were not achieved in peritoneal metastasis. The role of cytoreductive surgery (CRS) and proportion of the benefit from hyperthermic intraperitoneal chemotherapy (HIPEC) have been questioned. The PRODIGE 7 study aimed to assess the specific contribution of HIPEC to the survival benefit of peritoneal metastasis from colorectal cancer (CRC-PM) by grouping CRS alone versus CRS with oxaliplatin-based HIPEC, but failed to show any survival improvement. Of these criticisms, oxaliplatin resistance was suggested as the main cause of the negative result. In this regard, the relative resistance to oxaliplatin in consensus molecular subtype 4 colorectal cancer (CRC) is of great interest. Recent treatments for metastatic CRC have gradually moved to precision medicine based on individual biological information through high-throughput technology such as next generation sequencing. This review aimed to provide an overview of the current status of studies reporting the molecular knowledge of CRC-PM.
尽管有趋势表明,通过联合使用靶向药物,结直肠癌患者的生存率持续提高,但这种提高是有限的,在腹膜转移方面未实现具有临床意义的益处。细胞减灭术(CRS)的作用以及热灌注化疗(HIPEC)的获益比例受到了质疑。PRODIGE 7研究旨在通过比较单纯CRS与联合基于奥沙利铂的HIPEC的CRS,评估HIPEC对结直肠癌腹膜转移(CRC-PM)生存获益的具体贡献,但未显示出生存率的任何改善。在这些批评意见中,奥沙利铂耐药被认为是导致阴性结果的主要原因。在这方面,共识分子亚型4结直肠癌(CRC)对奥沙利铂的相对耐药性备受关注。近期,转移性CRC的治疗已逐渐转向基于个体生物学信息的精准医学,通过下一代测序等高通量技术实现。本综述旨在概述报告CRC-PM分子知识的研究现状。