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结直肠癌:遗传改变、新型生物标志物、当前治疗策略和临床试验。

Colorectal cancer: Genetic alterations, novel biomarkers, current therapeutic strategies and clinical trials.

机构信息

Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, United States.

Center for Drug Design, University of Minnesota, Minneapolis, MN 5545, United States.

出版信息

Gene. 2024 Jan 20;892:147857. doi: 10.1016/j.gene.2023.147857. Epub 2023 Sep 30.

Abstract

Colorectal cancer (CRC) is the third most commonly detected cancer with a serious global health issue. The rates for incidence and mortality for CRC are alarming, especially since the prognosis is abysmal when the CRC is diagnosed at an advanced or metastatic stage. Both type of (modifiable/ non-modifiable) types of risk factors are established for CRC. Despite the advances in recent technology and sophisticated research, the survival rate is still meager due to delays in diagnosis. Therefore, there is urgently required to identify critical biomarkers aiming at early diagnosis and improving effective therapeutic strategies. Additionally, a complete understanding of the dysregulated pathways like PI3K/Akt, Notch, and Wnt associated with CRC progression and metastasis is very beneficial in designing a therapeutic regimen. This review article focused on the dysregulated signaling pathways, genetics and epigenetics alterations, and crucial biomarkers of CRC. This review also provided the list of clinical trials targeting signaling cascades and therapies involving small molecules. This review discusses up-to-date information on novel diagnostic and therapeutic strategies alongside specific clinical trials.

摘要

结直肠癌(CRC)是第三大常见癌症,是全球严重的健康问题。CRC 的发病率和死亡率令人震惊,尤其是当 CRC 处于晚期或转移阶段时,预后极差。CRC 有两种类型(可改变/不可改变)的风险因素。尽管最近技术和复杂研究取得了进展,但由于诊断延误,生存率仍然很低。因此,迫切需要确定关键的生物标志物,以实现早期诊断和改进有效的治疗策略。此外,全面了解与 CRC 进展和转移相关的失调途径,如 PI3K/Akt、Notch 和 Wnt,对于设计治疗方案非常有益。本文综述了 CRC 的失调信号通路、遗传学和表观遗传学改变以及关键的生物标志物。本文还提供了针对信号级联和涉及小分子的治疗的临床试验列表。本文讨论了最新的关于新型诊断和治疗策略的信息,以及具体的临床试验。

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