Department of Medical Oncology, Henry Ford Cancer Center, Detroit, Michigan.
Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.
Clin Adv Hematol Oncol. 2024 Nov;22(9):455-463.
Colorectal cancer is the third most commonly diagnosed cancer in the United States. Approximately 20% of patients have metastatic disease at diagnosis, and a proportion of patients with initially localized disease will experience systemic disease recurrence. In the era of molecular subtyping, we have an increasing number of systemic therapies and the opportunity to individualize the treatment of patients with advanced disease. Nonetheless, the 5-year overall survival rate remains unsatisfactory for this patient population. Most patients will be treated with palliative cytotoxic therapy, often with an added monoclonal antibody. Molecular subtyping allows patients to receive targeted therapies upon further lines of therapy. A small portion of patients will have oligometastases that may be amenable to resection or locoregional therapies to help improve outcomes with systemic therapy. Here, we review the current treatment of patients with unresectable and resectable stage IV colorectal cancer, with a focus on pharmacologic therapies.
在美国，结直肠癌是第三大常见癌症。约 20%的患者在诊断时已发生转移，且一部分最初诊断为局限性疾病的患者会出现全身性疾病复发。在分子亚型分类时代，我们有越来越多的全身性治疗方法，有机会对晚期疾病患者进行个体化治疗。尽管如此，该患者群体的 5 年总生存率仍不理想。大多数患者将接受姑息性细胞毒性治疗，通常会添加单克隆抗体。分子亚型分类使患者在接受进一步治疗时可以接受靶向治疗。一小部分患者可能会出现寡转移灶，这些转移灶可能适合切除或局部区域治疗，以帮助改善全身性治疗的预后。在这里，我们回顾了不可切除和可切除的 IV 期结直肠癌患者的当前治疗方法，重点介绍了药物治疗。
