Currently, increasing evidence indicates that left-side colon cancer and right-side colon cancer have distinguished prognosis. Regarding to drug treatment, left-side colon cancer with wild-type RAS gene is more likely to benefit from EGFR-Ab treatment. By contrast, right-side colon cancer seems less sensitive to response to standard chemotherapy and target therapy. Besides RAS gene status and primary tumor location, how to enrich patients sensitive to EGFR-Ab treatment is still an unsolved question. Recent studies suggest that BRAF mutation, HER2 amplification and low expression of EGFR ligand are negatively predictive factors to EGFR-Ab treatment. Is there any strategy to improve the prognosis of right-side colon cancer? There are high rates of MSI-H, BRAF mutation and RAS mutations in right-side colon cancer. In the future, we are dependent on drugs targeting these biomarkers in combination with new therapeutic methods to improve the treatment efficacy of right-side colon cancer.%目前,越来越多的证据提示左、右半结肠癌是预后截然不同的疾病.就药物治疗而言,RAS野生型的左半结肠癌更有可能从表皮生长因子受体(epidermal growth factor receptor,EGFR)单抗治疗中获益,而右半结肠癌无论对标准化疗还是联合靶向治疗均不太敏感.但是,除了RAS基因状态及原发灶部位,如何进一步富集EGFR单抗治疗获益人群呢?近期研究显示BRAF突变、HER2扩增、EGFR配体低表达是EGFR单抗治疗的负性预测因素,而本身治疗效果不佳的右半结肠癌患者该如何改善预后?由于右半结肠癌微卫星不稳定比例高,BRAF突变及RAS突变率较高,所以未来我们可能还要依赖于这些特殊的分子靶点或联合多种治疗手段来提高疗效.
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