Colorectal Cancer Liver Metastasis—State-of-the-Art and Future Perspectives

Ana Ruivo, Rui Caetano Oliveira, P. Silva-Vaz, J. Tralhão
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Abstract

The current management of colorectal cancer liver metastasis (CRCLM) patients involves a multidisciplinary approach, with surgical resection remaining the primary curative option. The advances in liver surgery have improved outcomes, enabling more patients to undergo surgery successfully. In addition, the development of imaging software has improved the preoperative planning and patient selection for surgery and other interventions. Systemic therapies, such as targeted therapies and immunotherapies, have enhanced the chances of complete resection. Targeted agents, in combination with chemotherapy, have shown efficacy in downstaging tumors and increasing resectability. The algorithm approach for these patients continues to evolve, driven by a deeper understanding of the underlying biology. Personalized medicine, guided by molecular profiling and the potential of liquid biopsies in this field, may lead to more tailored treatment strategies. A greater understanding of the immune microenvironment in CRLM may unlock the potential for immune checkpoint inhibitors and novel immunotherapies to become more prominent in the treatment landscape. This review explores the current state-of-the-art treatment of CRCLM and discusses promising future perspectives.
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结直肠癌肝转移--最新进展与未来展望
目前对结直肠癌肝转移(CRCLM)患者的治疗涉及多学科方法,手术切除仍是主要的治愈选择。肝脏手术的进步改善了治疗效果,使更多患者能够成功接受手术。此外,成像软件的发展也改善了手术和其他干预措施的术前规划和患者选择。靶向疗法和免疫疗法等系统疗法提高了完全切除的几率。靶向药物与化疗的结合在降低肿瘤分期和增加可切除性方面显示出了疗效。随着对基础生物学的深入了解,针对这些患者的算法方法也在不断发展。以分子图谱为指导的个性化医疗以及液体活检在这一领域的潜力,可能会带来更具针对性的治疗策略。加深对 CRLM 免疫微环境的了解可能会释放出免疫检查点抑制剂和新型免疫疗法的潜力,使其在治疗领域变得更加突出。这篇综述探讨了目前最先进的 CRCLM 治疗方法,并讨论了前景广阔的未来展望。
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