Ruff Samantha M, Brown Zachary J, Pawlik Timothy M
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, 43210, USA.
Department of Surgery, Division of Surgical Oncology, New York University Long Island, Mineola, NY, USA.
Surg Oncol. 2023 Dec;51:101993. doi: 10.1016/j.suronc.2023.101993. Epub 2023 Sep 20.
Surgical resection is the cornerstone of treatment for metastatic colorectal cancer (CRC) and offers the best chance at long-term survival. Unfortunately, most patients do not present with resectable metastatic disease and, among patients who do undergo curative-intent resection, many will develop recurrence. In turn, patients require a multi-disciplinary treatment approach with a combination of chemotherapy, surgery, radiation, and/or liver directed therapies that is guided by patient disease burden and clinical status. The development of targeted therapies has led to varying success in other cancers and has emerged as a treatment option for patients with metastatic CRC. While cytotoxic chemotherapy aims to kill cells as they replicate, targeted therapies are directed at biologic features of cancers, like angiogenesis or immune checkpoints. Targeted therapy can facilitate a more treatment tailored approach to the unique genomic alterations of the tumor and hopefully deliver more personalized therapy. We herein provide a systematic review of approved targeted therapies and immune checkpoint inhibitors for metastatic CRC and provide an overview of the current literature.
手术切除是转移性结直肠癌（CRC）治疗的基石，也是实现长期生存的最佳机会。不幸的是，大多数患者就诊时已出现不可切除的转移性疾病，而在接受根治性切除的患者中，许多人会出现复发。相应地，患者需要多学科治疗方法，结合化疗、手术、放疗和/或肝脏定向治疗，这要根据患者的疾病负担和临床状况来指导。靶向治疗的发展在其他癌症中取得了不同程度的成功，并已成为转移性CRC患者的一种治疗选择。细胞毒性化疗旨在在癌细胞复制时将其杀死，而靶向治疗则针对癌症的生物学特征，如血管生成或免疫检查点。靶向治疗可以促进针对肿瘤独特基因组改变的更具针对性的治疗方法，并有望提供更个性化的治疗。我们在此对已批准的转移性CRC靶向治疗和免疫检查点抑制剂进行系统综述，并概述当前的文献。
