Resectable Colorectal Cancer: Current Perceptions on the Correlation of Recurrence Risk, Microbiota and Detection of Genetic Mutations in Liquid Biopsies.
Resectable Colorectal Cancer: Current Perceptions on the Correlation of Recurrence Risk, Microbiota and Detection of Genetic Mutations in Liquid Biopsies.
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可切除的结直肠癌：当前对复发风险，微生物群和液体活检中基因突变检测的看法。
DOI：
10.3390/cancers13143522
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发表时间：
2021-07-14
期刊：
影响因子：
5.2
通讯作者：
Souglakos J
中科院分区：
文献类型：
--
作者：
Koulouris A;Tsagkaris C;Messaritakis I;Gouvas N;Sfakianaki M;Trypaki M;Spyrou V;Christodoulakis M;Athanasakis E;Xynos E;Tzardi M;Mavroudis D;Souglakos J
结直肠癌复发仍然是疾病管理的一大障碍。转移性疾病是一种高度致命的恶性肿瘤。迫切需要新的生物标记物来解决疾病的复发，因为特定的基因特征可以识别更高或更低的复发风险，从而作为生物标记物和治疗靶点。在很大程度上，结直肠癌是通过肠道微生物区系的免疫和炎症相互作用而调节的。澄清这些机制将产生新的机会，导致适当的分层政策，并实现更精确、个性化的监测和治疗导航。从这个角度来看，及早发现结直肠癌术后复发至关重要。正在进行的以CTCs为重点的试验，甚至更多关于CTDNA的试验，似乎为有希望的、微创和挽救生命的监测铺平了道路，支持个性化治疗并有利于患者的生活质量。转移性结直肠癌(MCRC)仍然是一种高度致命的恶性肿瘤，尽管在指导现有治疗的最佳使用方面的分子变化已经导致了相当大的进展。结直肠癌复发仍然是疾病管理的一大障碍。因此，焦点转向关于可切除结直肠癌患者复发危险因素的新绘制的领域，重点是基因突变、微生物区系重塑和液体活检。迫切需要新的生物标记物来解决疾病的复发，因为特定的基因特征可以识别更高或更低的复发风险(RR)，从而既可以用作生物标记物，也可以作为治疗靶点。在很大程度上，结直肠癌是通过肠道微生物区系的免疫和炎症相互作用而调节的。澄清这些机制将产生新的机会，不仅导致适当的分层政策，而且还导致更精确、个性化的监测和治疗导航。从这个角度来看，及早发现结直肠癌术后复发至关重要。正在进行的试验侧重于循环肿瘤细胞(CTCs)，更重要的是循环肿瘤DNA(CTDNA)，似乎为有希望的、微创但准确和拯救生命的监测铺平了道路，不仅支持个性化治疗，而且有利于患者的生活质量。
CRC recurrence remains a great barrier in the disease management. Metastatic disease is a highly lethal malignancy. Novel biomarkers are urgently needed to address disease recurrence since specific genetic signatures can identify a higher or lower recurrence risk, thus serving as biomarkers and treatment targets. To a large extent, CRC is mediated by the immune and inflammatory interplay of microbiota, through intestinal dysbiosis. Clarification of these mechanisms will yield new opportunities, leading to appropriate stratification policies, and to more precise, personalized monitoring and treatment navigation. Under this perspective, early detection of post-operative CRC recurrence is of utmost importance. Ongoing trials, focusing on CTCs and, even more on ctDNA, seem to pave the way to a promising, minimally invasive, and life-saving monitoring, supporting personalized treatment and favoring patients’ quality of life. Metastatic colorectal cancer (mCRC) remains a highly lethal malignancy, although considerable progress has resulted from molecular alterations in guiding optimal use of available treatments. CRC recurrence remains a great barrier in the disease management. Hence, the spotlight turns to newly mapped fields concerning recurrence risk factors in patients with resectable CRC with a focus on genetic mutations, microbiota remodeling and liquid biopsies. There is an urgent need for novel biomarkers to address disease recurrence since specific genetic signatures can identify a higher or lower recurrence risk (RR) and, thus, be used both as biomarkers and treatment targets. To a large extent, CRC is mediated by the immune and inflammatory interplay of microbiota, through intestinal dysbiosis. Clarification of these mechanisms will yield new opportunities, leading not only to the appropriate stratification policies, but also to more precise, personalized monitoring and treatment navigation. Under this perspective, early detection of post-operative CRC recurrence is of utmost importance. Ongoing trials, focusing on circulating tumor cells (CTCs) and, even more, circulating tumor DNA (ctDNA), seem to pave the way to a promising, minimally invasive but accurate and life-saving monitoring, not only supporting personalized treatment but favoring patients’ quality of life, as well.
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