晚期结肠直肠癌的治疗选择:从最近的随机研究中吸取的教训
Line Schmidt Tarpgaard1,2, Stine Brændegaard Winther1, Per Pfeiffer1,2
1Department of Oncology, Odense University Hospital, 5000 Odense C, Denmark.
Cancers
|January 11, 2024
概括
转移性结直肠癌 (mCRC) 治疗的近期进展提供了新的后期选择. 针对特定瘤突变的个性化疗法,如BRAF或KRAS G12C,现在可用于晚期疾病患者.
科学领域:
- 在瘤学瘤学.
- 医学遗传学 医学遗传学
- 临床药理学 临床药理学
背景情况:
- 转移性结直肠癌 (mCRC) 的全身治疗在过去二十年中发生了显著的进化.
- 早期批准的药物包括5-甲 (5FU),氧化和虹膜的组合,以及抗血管原和抗EGFR抗体.
- 后来的进展引入了雷戈拉费尼布和trifluridine/tipiracil用于后期治疗.
研究的目的:
- 审查最新的临床数据关于mCRC的晚期治疗选择.
- 专注于随机临床试验的证据,如果有.
- 为未经选择的患者群体和具有特定分子瘤形状的患者群体提供建议.
主要方法:
- 关于晚期mCRC治疗的最新临床数据的文献综述.
- 强调随机对照试验.
- 基于分子分析的治疗疗效分析.
主要成果:
- 已建立的第一线和二线疗法已被新药增加,如regorafenib和trifluridine/tipiracil.
- 分子造型识别能够识别出受益于向治疗的不同患者亚组.
- 特定突变 (BRAF,KRAS G12C),HER2放大,MMR缺陷和NTRK基因融合指导了个性化的治疗选择.
结论:
- 通过分子分析了解瘤生物学对于优化晚期mCRC治疗至关重要.
- 个性化治疗策略对于改善晚期结直肠癌的治疗结果越来越重要.
- 在mCRC中提供了一般和突变特异的后期治疗方法的建议.
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