Colorectal cancer (CRC) is the second-leading cause of cancer-related mortality worldwide. CRC mortality results almost exclusively from metastatic disease (mCRC) for which systemic chemotherapy is often a preferred therapeutic option. Biomarker-based stratification of mCRC enables the use of precision therapy based on individual tumor mutational profiles. Activating mutations in the RAS/RAF/MAPK pathway downstream of EGFR signaling have, until recently, limited the use of EGFR-targeted therapies for mCRC; however, the development of anti-RAS and anti-RAF therapies together with improved strategies to limit compensatory signaling pathways is resulting in improved survival rates in several highly lethal mCRC sub-types (e.g., BRAF-mutant). The use of fluoropyrimidine (FP)-based chemotherapy regimens to treat mCRC continues to evolve contributing to improved long-term survival. Future advances in chemotherapy for mCRC will need to position development relative to the advances made in precision oncology.
结直肠癌（CRC）是全球癌症相关死亡的第二大原因。其死亡率几乎完全由转移性疾病（mCRC）导致，而系统性化疗常作为首选治疗方案。基于生物标志物的mCRC分层使得根据个体肿瘤突变谱进行精准治疗成为可能。近期之前，EGFR信号通路下游RAS/RAF/MAPK通路的激活突变限制了EGFR靶向疗法在mCRC中的应用；然而，随着抗RAS和抗RAF疗法的研发，以及抑制代偿性信号通路策略的改进，多种高致死性mCRC亚型（如BRAF突变型）的生存率正得到提升。基于氟嘧啶（FP）的化疗方案在治疗mCRC中的应用持续演进，有助于改善长期生存。未来mCRC化疗的进展需结合精准肿瘤学的发展进行定位。
Recent Advances in Therapeutic Strategies to Improve Colorectal Cancer Treatment
肿瘤(癌症)患者之家