Current and future targets and therapies in metastatic colorectal cancer
Miljana Dzunic1, Ivan Petkovic, Ana Cvetanovic
1Clinic of Oncology, Clinical Center Nis, Serbia.
Abstract:
Colorectal cancer (CRC) is the third most common cancer and the second cause of cancer-related deaths worldwide. Despite early diagnosis and treatment improvement, the majority of patients will still suffer from metastatic disease (mCRC), which has a poor prognosis. Molecular diversity of CRC requires personalized targeted approach for improving patient outcomes. Antiangiogenic agents proved to be beneficial in the continuum of mCRC treatment. For efficient epidermal growth factor receptor (EGFR) directed therapy, subtle molecular selection and better strategies to overcome resistance are needed. BRAF mutant and HER-2 positive mCRC will soon be provided with approved targeted treatments and check-point inhibitors demonstrated effectiveness in microsatellite instability (MSI) - high mCRC. Moreover, numeorous promising agents are entering clinical trial arena. This review summarizes actual and possible targets and current and promising agents for mCRC treatment. With broader accessibility of liquid biopsy we could track molecular evolution of CRC and target genetic alterations as they emerge.
Insights
Metastatic colorectal cancer (mCRC) treatment is advancing with targeted therapies and immunotherapies. Liquid biopsy aids in tracking molecular changes for personalized treatment strategies in mCRC.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Biology
Background:
- Colorectal cancer (CRC) is a leading cause of cancer death globally.
- Metastatic CRC (mCRC) presents a poor prognosis despite treatment advances.
- The molecular heterogeneity of CRC necessitates personalized therapeutic strategies.
Purpose of the Study:
- To review current and emerging targeted therapies for mCRC.
- To discuss strategies for overcoming resistance to epidermal growth factor receptor (EGFR) therapy.
- To highlight the potential of novel agents and diagnostic tools in mCRC management.
Main Methods:
- Literature review of current and clinical trial data on mCRC treatments.
- Analysis of molecular targets and resistance mechanisms in CRC.
- Evaluation of the role of emerging technologies like liquid biopsy.
Main Results:
- Antiangiogenic agents are beneficial in mCRC treatment.
- Targeted therapies for BRAF-mutant and HER2-positive mCRC are emerging.
- Immune checkpoint inhibitors show efficacy in microsatellite instability-high (MSI-high) mCRC.
Conclusions:
- Personalized medicine, driven by molecular profiling, is crucial for improving mCRC outcomes.
- Emerging targeted agents and immunotherapies offer new hope for mCRC patients.
- Liquid biopsy can facilitate real-time monitoring of molecular evolution and guide treatment adjustments in mCRC.
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