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结直肠癌精准医学方法的进展:从分子剖析到靶向治疗。

Advances in Precision Medicine Approaches for Colorectal Cancer: From Molecular Profiling to Targeted Therapies.

作者信息

Kiran Neelakanta Sarvashiva, Yashaswini Chandrashekar, Maheshwari Rahul, Bhattacharya Sankha, Prajapati Bhupendra G

机构信息

Department of Biotechnology, School of Applied Sciences, REVA University, Bengaluru, Karnataka 560064, India.

School of Pharmacy and Technology Management, SVKM's Narsee Monjee Institute of Management Studies (NMIMS) Deemed-to-University, Green Industrial Park, TSIIC,, Jadcherla, Hyderabad 509301, India.

出版信息

ACS Pharmacol Transl Sci. 2024 Mar 19;7(4):967-990. doi: 10.1021/acsptsci.4c00008. eCollection 2024 Apr 12.

Abstract

Precision medicine is transforming colorectal cancer treatment through the integration of advanced technologies and biomarkers, enhancing personalized and effective disease management. Identification of key driver mutations and molecular profiling have deepened our comprehension of the genetic alterations in colorectal cancer, facilitating targeted therapy and immunotherapy selection. Biomarkers such as microsatellite instability (MSI) and DNA mismatch repair deficiency (dMMR) guide treatment decisions, opening avenues for immunotherapy. Emerging technologies such as liquid biopsies, artificial intelligence, and machine learning promise to revolutionize early detection, monitoring, and treatment selection in precision medicine. Despite these advancements, ethical and regulatory challenges, including equitable access and data privacy, emphasize the importance of responsible implementation. The dynamic nature of colorectal cancer, with its tumor heterogeneity and clonal evolution, underscores the necessity for adaptive and personalized treatment strategies. The future of precision medicine in colorectal cancer lies in its potential to enhance patient care, clinical outcomes, and our understanding of this intricate disease, marked by ongoing evolution in the field. The current reviews focus on providing in-depth knowledge on the various and diverse approaches utilized for precision medicine against colorectal cancer, at both molecular and biochemical levels.

摘要

精准医学正在通过整合先进技术和生物标志物来改变结直肠癌的治疗方式,加强个性化且有效的疾病管理。关键驱动突变的识别和分子图谱分析加深了我们对结直肠癌基因改变的理解,促进了靶向治疗和免疫治疗的选择。微卫星不稳定性(MSI)和DNA错配修复缺陷(dMMR)等生物标志物指导治疗决策,为免疫治疗开辟了道路。液体活检、人工智能和机器学习等新兴技术有望彻底改变精准医学中的早期检测、监测和治疗选择。尽管取得了这些进展,但包括公平获取和数据隐私在内的伦理和监管挑战凸显了负责任实施的重要性。结直肠癌具有肿瘤异质性和克隆进化的动态特性,这强调了适应性和个性化治疗策略的必要性。结直肠癌精准医学的未来在于其增强患者护理、临床结局以及我们对这种复杂疾病理解的潜力,该领域的不断发展便是明证。当前的综述着重于在分子和生化层面提供关于用于结直肠癌精准医学的各种不同方法的深入知识。

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