Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Department of Hematology-Oncology, National University Cancer Institute, Singapore, National University Health System, Singapore.
Am Soc Clin Oncol Educ Book. 2024 Jun;44(3):e438466. doi: 10.1200/EDBK_438466.
Colorectal cancer (CRC) remains a significant global health challenge, ranking among the leading causes of cancer-related morbidity and mortality worldwide. Recent advancements in molecular characterization have revolutionized our understanding of the heterogeneity within colorectal tumors, particularly in the context of tumor sidedness. Tumor sidedness, referring to the location of the primary tumor in either the right or left colon, has emerged as a critical factor influencing prognosis and treatment responses in metastatic CRC. Molecular underpinnings of CRC, the impact of tumor sidedness, and how this knowledge guides therapeutic decisions in the era of precision medicine have led to improved outcomes and better quality of life in patients. The emergence of circulating tumor DNA as a prognostic and predictive tool in CRC heralds promising advancements in the diagnosis and monitoring of the disease. This innovation facilitates better patient selection for exploration of additional treatment options. As the field progresses, with investigational agents demonstrating potential as future treatments for refractory metastatic CRC, new avenues for enhancing outcomes in this challenging disease are emerging.
结直肠癌（CRC）仍然是一个重大的全球健康挑战，是全球癌症相关发病率和死亡率的主要原因之一。近年来，分子特征的研究进展彻底改变了我们对结直肠肿瘤异质性的认识，尤其是在肿瘤侧别方面。肿瘤侧别是指原发肿瘤位于右结肠或左结肠的位置，它已成为影响转移性 CRC 预后和治疗反应的关键因素。CRC 的分子基础、肿瘤侧别的影响，以及在精准医学时代，这些知识如何指导治疗决策，都使患者的结局和生活质量得到了改善。循环肿瘤 DNA 作为 CRC 的一种预后和预测工具的出现，预示着该疾病的诊断和监测方面有很有前景的进展。这一创新为探索更多治疗选择的患者提供了更好的选择。随着研究药物作为难治性转移性 CRC 的潜在未来治疗方法的出现，这种具有挑战性疾病的治疗效果也在不断提高。
