Targeted therapy in metastatic colorectal cancer -- an example of personalised medicine in action.

摘要: In metastatic colorectal cancer (mCRC), an improved understanding of the underlying pathology and molecular biology has successfully merged with advances in diagnostic techniques local/systemic therapies as well improvements functioning multidisciplinary teams, to enable tailored treatment regimens optimized outcomes. Indeed, a result these advancements, median survival for patients mCRC is now range 20-24months, having approximately tripled last 20years. The identification KRAS negative predictive marker activity epidermal growth factor receptor (EGFR)-targeted monoclonal antibodies (mAbs), such panitumumab (Amgen, Thousand Oaks, USA) cetuximab (ImClone, Branchburg, USA), perhaps had greatest impact on patient management. This meant that, first time, unlikely respond targeted therapy could be defined ahead treatment. Ongoing controversies whether G13D- (or BRAF V600-) mutated tumours can still EGFR-targeted mAbs potential inter- intra-tumour heterogeneity tumour sampling show that usefulness biomarker not yet been exhausted, other downstream biomarkers should considered. Conversely, anti-angiogenic agents bevacizumab (Genentech, San Francisco, setting lacking. this review we will discuss discovery ongoing investigation into how recent have impacted clinical practice ultimately overall cost patients.