Richard Mirjam, Koch Christine, Trojan Jörg
Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
Radiologie (Heidelb). 2025 Apr 24. doi: 10.1007/s00117-025-01455-9.
In recent years the treatment options for metastatic colorectal cancer have significantly improved. This progress has particularly benefited specific subgroups of patients identified by certain biomarkers, such as those with a microsatellite instability, patients with B‑Raf (BRAF) V600E mutation, Kirsten rat sarcoma (KRAS) G12C mutation or v‑erb-b2 erythroblastic leukemia viral oncogene homolog 2 (ERBB2) amplification. Additionally, targeted anti-epidermal growth factor (EGF) receptor therapy can be more effectively utilized through further patient selection. For patients who no longer respond to treatment, the new standard trifluridine/tipiracil in combination with bevacizumab has become established as the new third-line option. Furthermore, the selectively anti-angiogenic tyrosine kinase inhibitor fruquintinib has recently been approved as a last-line treatment. This article provides an overview of current standards and future developments in therapy.
近年来，转移性结直肠癌的治疗选择有了显著改善。这一进展尤其使某些生物标志物所确定的特定患者亚组受益，例如微卫星不稳定患者、B-Raf（BRAF）V600E突变患者、 Kirsten大鼠肉瘤（KRAS）G12C突变患者或v-erb-b2成红细胞白血病病毒癌基因同源物2（ERBB2）扩增患者。此外，通过进一步的患者选择，可以更有效地利用靶向抗表皮生长因子（EGF）受体疗法。对于不再对治疗有反应的患者，新的标准三联疗法曲氟尿苷/替匹嘧啶联合贝伐单抗已成为新的三线治疗选择。此外，选择性抗血管生成酪氨酸激酶抑制剂呋喹替尼最近已被批准作为一线治疗药物。本文概述了当前的治疗标准和未来的治疗进展。
