摘要
结直肠癌(CRC)是一种异质性疾病,在分子癌变和形态癌变多步途径方面都是如此。由于不同致癌途径所涉及的遗传和表观遗传机制的差异,CRC内存在着相当大的异质性。对肿瘤病理生理学的深入了解是发展现代成功的治疗转移性大肠癌的有效手段所必需的。在过去的5年中,人们对结直肠癌的分子分类产生了极大的兴趣,因为它对于预测预后和指导个性化治疗都具有重要的临床意义。最近,结直肠癌亚型联合会确定了四种共同的分子亚型,即CRC中的CMS 1-4;然而,利用分子特征对CRC进行分层以用于预后和临床条件下的预测目的尝试取得了有限的成功。在这篇综述中,我们重点讨论了包括特定突变在内的CRC的分子定义亚型,并讨论了对目前和未来转移性CRC患者进行治疗的意义,以实现对每个患者的最大治疗反应,同时减少治疗的副作用。
关键词: 共识分子亚型,大肠癌,化疗,癌变,染色体不稳定,微卫星不稳定。
图形摘要
Current Drug Targets
Title:Genetic Molecular Subtypes in Optimizing Personalized Therapy for Metastatic Colorectal Cancer
Volume: 19 Issue: 15
关键词: 共识分子亚型,大肠癌,化疗,癌变,染色体不稳定,微卫星不稳定。
摘要: Colorectal cancer (CRC) is a heterogeneous disease entity in terms of both molecular carcinogenesis and morphologic carcinogenesis multistep pathways. Considerable heterogeneity exists within CRC due to the varied genetic and epigenetic mechanisms involved in different carcinogenesis pathways. A better understanding of pathophysiology of tumors is necessary to develop modern and successful means of treatment in metastatic CRC. Over the last 5 years, there has been a surge in interest in the molecular classification of colorectal cancer, as its clinical importance both for predicting prognosis and in guiding personalized treatment had been acknowledged. Recently, the Colorectal Cancer Subtyping Consortium identified four consensus molecular subtypes, CMS 1-4 in CRC; however, attempts to stratify CRC using molecular features for prognostic and predictive purposes in clinical conditions had limited success. In this review, we focused on molecularly defined subtypes of CRC including specific mutations and discuss implications for current and future patient management in metastatic CRC to achieve the maximal therapeutic response for each patient, while reducing adverse side effects of therapy.
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Cite this article as:
Genetic Molecular Subtypes in Optimizing Personalized Therapy for Metastatic Colorectal Cancer, Current Drug Targets 2018; 19 (15) . https://dx.doi.org/10.2174/1389450119666180803122744
DOI https://dx.doi.org/10.2174/1389450119666180803122744 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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