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Current and advancing treatments for metastatic colorectal cancer

机译：转移性大肠癌的最新治疗方法

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Introduction: Colorectal cancer (CRC) is one of the leading causes of cancer deaths worldwide. Despite the introduction of several new drugs targeting the vascular endothelial growth factor or epidermal growth factor receptor (EGFR) signaling pathways, survival and disease control in metastatic CRC remains poor.Areas covered: Chemotherapy based on fluoropyrimidines and irinotecan or oxaliplatin has been the cornerstone of CRC standard of care for several decades. Optimal regimens are selected according to toxicity profiles and patient characteristics. The addition of targeted drugs inhibiting angiogenesis, notably bevacizumab, aflibercept and ramucirumab, has improved chemotherapy outcomes in metastatic CRC. Anti-EGFR agents, cetuximab and panitumumab, in combination with chemotherapy have also improved survival in patients with wild-type RAS tumors. In the refractory setting, there are emerging drugs such as regorafenib or TAS-102 that also have demonstrated impact on outcomes.Expert opinion: Drugs targeting signaling pathways involved in tumorigenesis improve patient outcomes over chemotherapy alone. Determining the most suitable combination and sequence should be carefully selected, with studies yet to provide a definitive solution to this unknown. Molecular mechanisms of colorectal cancer are at the forefront of research. Knowledge in this domain will help overcome resistance to therapies and introduce new drugs in the personalized CRC therapeutic scenario.
机译：简介：大肠癌（CRC）是全球癌症死亡的主要原因之一。尽管引入了几种针对血管内皮生长因子或表皮生长因子受体（EGFR）信号通路的新药，但转移性CRC的存活率和疾病控制仍然很差。 CRC的护理标准已有几十年了。根据毒性特征和患者特征选择最佳方案。添加抑制血管生成的靶向药物，尤其是贝伐单抗，阿柏西普和雷莫昔单抗，可改善转移性CRC的化疗效果。抗EGFR药物西妥昔单抗和帕尼单抗与化学疗法联合也可以改善野生型RAS肿瘤患者的生存率。在难治性环境中，出现了瑞戈非尼或TAS-102等新兴药物，这些药物也已显示出对结局的影响。应仔细选择确定最合适的组合和顺序，但尚需进行研究以提供针对此未知问题的明确解决方案。大肠癌的分子机制处于研究的最前沿。该领域的知识将有助于克服对疗法的抵抗力，并在个性化CRC治疗方案中引入新药。

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