选择微卫星稳定和非突变RAS/BRAF转移性结肠直肠癌的最佳第一线治疗方法
Oluwadunni E Emiloju1, Mojun Zhu2, Hao Xie2
1Division of Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Emiloju.Oluwadunni@mayo.edu.
Current treatment options in oncology
|November 15, 2023
概括
标准的转移性结直肠癌 (CRC) 治疗将化疗与生物药物结合起来. 对CRC的治疗选择取决于MMR,RAS/BRAF状态,瘤位置和患者因素等生物标志物.
科学领域:
- 在瘤学瘤学.
- 医学遗传学 医学遗传学
背景情况:
- 转移性结直肠癌 (mCRC) 的标准前线治疗包括细胞毒性化疗与抗EGFR或抗VEGF抗体等生物药物相结合.
- 治疗选择的关键预测生物标志物包括不匹配修复 (MMR) 状态和RAS/BRAF突变状态.
研究的目的:
- 概述当前在转移性结直肠癌中选择前线治疗的策略.
- 突出预测生物标志物和临床因素在个性化mCRC治疗中的作用.
主要方法:
- 审查当前的临床指南和有关mCRC治疗的数据.
- 预测生物标志物 (MMR,RAS,BRAF) 和临床因素 (瘤位置,患者特征) 的分析.
主要成果:
- 化疗方案 (单剂,双剂或三剂) 是mCRC治疗的组成部分.
- 添加抗VEGF或抗EGFR疗法是由预测生物标志物指导的.
- 有针对左侧 (抗EGFR + 双重化疗) 与右侧 (抗VEGF + 双重/三重化疗) 主要瘤的具体建议,适用于熟练的MMR和RAS/BRAF野生型mCRC的患者.
结论:
- 前线mCRC治疗是基于分子生物标志物和临床因素的组合来个性化.
- 需要对新型预测生物标志物的进一步研究,以加强对mCRC的个性化治疗策略.
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