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个性化医学在结肠癌治疗中的应用:最新进展、局限性和未来展望。

Recent Advancements, Limitations, and Future Perspectives of the use of Personalized Medicine in Treatment of Colon Cancer.

机构信息

Faculty of Allied Health Sciences, Chettinad Academy of Research and Education, Chettinad Hospital and Research Institute, Chennai, India.

Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Bialystok, Białystok, Poland.

出版信息

Technol Cancer Res Treat. 2023 Jan-Dec;22:15330338231178403. doi: 10.1177/15330338231178403.

Abstract

Due to the heterogeneity of colon cancer, surgery, chemotherapy, and radiation are ineffective in all cases. The genomic profile and biomarkers associated with the process are considered in personalized medicine, along with the patient's personal history. It is based on the response of the targeted therapies to specific genetic variations. The patient's genetic transcriptomic and epigenetic features are evaluated, and the best therapeutic approach and diagnostic testing are identified through personalized medicine. This review aims to summarize all the necessary, updated information on colon cancer related to personalized medicine. Personalized medicine is gaining prominence as generalized treatments are finding it challenging to contain colon cancer cases which currently rank fourth among global cancer incidence while being the fifth largest in total death cases worldwide. In personalized therapy, patients are grouped into specific categories, and the best therapeutic approach is chosen based on evaluating their molecular features. Various personalized strategies are currently being explored in the treatment of colon cancer involving immunotherapy, phytochemicals, and other biomarker-specific targeted therapies. However, significant challenges must be overcome to integrate personalized medicine into healthcare systems completely. We look at the various signaling pathways and genetic and epigenetic alterations associated with colon cancer to understand and identify biomarkers useful in targeted therapy. The current personalized therapies available in colon cancer treatment and the strategies being explored to improve the existing methods are discussed. This review highlights the advantages and limitations of personalized medicine in colon cancer therapy. The current scenario of personalized medicine in developed countries and the challenges faced in middle- and low-income countries are also summarized. Finally, we discuss the future perspectives of personalized medicine in colon cancer and how it could be integrated into the healthcare systems.

摘要

由于结肠癌的异质性,手术、化疗和放疗在所有情况下都无效。在个性化医学中,除了考虑患者的个人病史外,还考虑与该过程相关的基因组特征和生物标志物。这是基于靶向治疗对特定遗传变异的反应。评估患者的遗传转录组和表观遗传特征,并通过个性化医学确定最佳治疗方法和诊断测试。

这篇综述旨在总结与个性化医学相关的所有必要的、最新的结肠癌信息。个性化医学越来越受到重视,因为一般治疗方法发现难以控制结肠癌病例,目前结肠癌在全球癌症发病率中排名第四,而在全球总死亡病例中排名第五。在个性化治疗中,患者被分为特定类别,并根据评估他们的分子特征来选择最佳治疗方法。目前,正在探索各种个性化策略来治疗结肠癌,包括免疫疗法、植物化学物质和其他针对生物标志物的靶向治疗。然而,要将个性化医学完全纳入医疗保健系统,还必须克服重大挑战。我们研究了与结肠癌相关的各种信号通路以及遗传和表观遗传改变,以了解和识别在靶向治疗中有用的生物标志物。讨论了结肠癌治疗中现有的个性化疗法以及正在探索的改善现有方法的策略。

本综述强调了个性化医学在结肠癌治疗中的优势和局限性。还总结了发达国家个性化医学的现状以及中低收入国家面临的挑战。最后,我们讨论了个性化医学在结肠癌中的未来前景以及如何将其纳入医疗保健系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ff9/10240881/962c6c79e7ac/10.1177_15330338231178403-fig1.jpg

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