转移性结直肠癌的新分子靶向治疗

J. Jo
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引用次数: 1

摘要

在过去的十年中,转移性结直肠癌(mCRC)的个体化治疗策略取得了实质性进展。基于预测性生物标志物,如微卫星不稳定性、RAS和BRAF突变、HER2扩增或NTRK融合,治疗策略已根据其分子和遗传特征进行了开发和分类。随着分子和基因预测测试的常规实施,mCRC治疗策略面临新的挑战。对于对抗上皮生长因子受体治疗有反应的患者,扩大的生物标志物面板可以选择定制治疗并确定最佳治疗。没有有效靶向治疗的BRAF V600E突变的mCRC患者有有效的治疗选择。有吸引力但罕见的靶点,如HER2扩增和NTRK融合,可能是一个突破,在错配修复缺陷/微卫星不稳定患者中使用免疫检查点抑制剂是一场引人注目的革命。在这篇综述中,我们总结了mCRC患者靶向治疗的现状,重点介绍了上皮生长因子受体阻断和新兴生物标志物的新进展。(梨花医学杂志;2021;44(1):11-18)
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New Molecular Targeted Therapy of Metastatic Colorectal Cancer
Over the past decade, substantial advances have been made in the individualization of therapeutic strategies for metastatic colorectal cancer (mCRC). Treatment strategies have been developed and classified according to their molecular and genetic character-istics based on predictive biomarkers such as microsatellite instability, RAS and BRAF mutations, HER2 amplification, or NTRK fusions. As molecular and genetic predictive tests are routinely performed, new challenges for mCRC treatment strategies are al-lowed. For patients responding to anti-epithelial growth factor receptor treatments, expanded biomarkers panels enable customized treatment to be selected and the optimal treatment can be determined. Patients with mCRC with the BRAF V600E mutation who did not have effective targeted treatments have effective therapeutic options. Attractive but rare targets, such as HER2 amplification and NTRK fusions, could be a breakthrough and the use of immune checkpoint inhibitors in patients with mismatch repair deficiency/microsatellite instability is the striking revolution. In this review, we summarize the current landscape of targeted therapies for mCRC patients, with a focus on new developments for epithelial growth factor receptor blockade and emerging biomarkers. (Ewha Med J 2021;44(1):11-18)
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