Sustainable Clinical Development of Adjuvant Chemotherapy for Colon Cancer.
Sustainable Clinical Development of Adjuvant Chemotherapy for Colon Cancer.
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DOI：
10.1002/ags3.12503
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发表时间：
2022-01
影响因子：
2.7
通讯作者：
Mori M
中科院分区：
文献类型：
--
作者：
Oki E;Ando K;Taniguchi H;Yoshino T;Mori M
已经进行了许多辅助环境下的临床研究，5-氟尿嘧啶和奥沙利铂的联合治疗已被确定为III期的标准治疗方法，并作为II期高危患者的选择。生物制剂，如贝伐单抗和抗表皮生长因子受体抗体，未能显示出额外的生存益处。根据病理分期确定了辅助化疗的适应证。然而，病理诊断并不一定会导致最佳治疗的选择。为了改善治疗决策，许多试验的目标是利用基因组测试将患者分成不同的治疗组。最近，基因标志物、免疫核心和循环肿瘤DNA(CtDNA)检测已有报道，其中ctDNA被认为是一种有前途的准确预测复发的标志物。对ctDNA阳性患者进行积极的化疗可能会降低复发率。最终目标是准确预测结肠癌患者的复发风险并防止复发。本文就辅助化疗的临床进展和根据复发风险对患者进行分层以及辅助化疗的未来发展方向作一综述。虽然辅助化疗已被证明可以降低II期和III期结肠癌(CC)的复发风险，但需要更好的预后和预测性生物标志物来对患者进行分层治疗。在本文中，我们将重点介绍辅助化疗的发展和根据复发风险对患者进行分层以及辅助化疗的未来发展方向。
Numerous clinical studies in an adjuvant setting have been conducted and the combination therapy of 5‐fluorouracil and oxaliplatin has been established as the standard treatment for Stage III and as an option for high‐risk Stage II patients. Biologics such as bevacizumab and antiepidermal growth factor receptor antibodies have failed to show additional survival benefits. The indication of adjuvant chemotherapy has been determined according to the pathological stage. Nevertheless, a pathological diagnosis does not necessarily result in selection of the optimal treatment. To improve treatment decisions, many trials have aimed to stratify patients into treatment groups using genomic testing. Recently, gene signature, Immunoscore, and circulating tumor DNA (ctDNA) assays have been reported and among them, ctDNA was shown to be a promising accurate predictive marker for recurrence. Treatment of ctDNA‐positive patients with aggressive chemotherapy may reduce recurrence rates. The ultimate goal is to accurately predict the risk of recurrence and to prevent recurrence in colon cancer patients. In this review we focus on the clinical development of adjuvant chemotherapy and stratification of patients according to risk of recurrence and the future direction of adjuvant chemotherapy. While adjuvant chemotherapy has been shown to reduce the recurrence risk in Stage II and III colon cancer (CC), better prognostic and predictive biomarkers are needed to stratify patients for treatment. In this review we focus on the development of adjuvant chemotherapy and stratification of patients according to risk of recurrence and the future direction of adjuvant chemotherapy.
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影响因子：
5.2
作者：
Chakrabarti S;Xie H;Urrutia R;Mahipal A
通讯作者：
Mahipal A
影响因子：
3.8
作者：
Clark-Langone KM;Sangli C;Krishnakumar J;Watson D
通讯作者：
Watson D
影响因子：
45.3
作者：
Cohen, Romain;Taieb, Julien;Shi, Qian
通讯作者：
Shi, Qian
DOI：
10.1056/nejmoa1713709
发表时间：
2018-03-29
期刊：
The New England journal of medicine
影响因子：
--
作者：
Grothey A;Sobrero AF;Shields AF;Yoshino T;Paul J;Taieb J;Souglakos J;Shi Q;Kerr R;Labianca R;Meyerhardt JA;Vernerey D;Yamanaka T;Boukovinas I;Meyers JP;Renfro LA;Niedzwiecki D;Watanabe T;Torri V;Saunders M;Sargent DJ;Andre T;Iveson T
通讯作者：
Iveson T
影响因子：
3.4
作者：
Huang J;Nair SG;Mahoney MR;Nelson GD;Shields AF;Chan E;Goldberg RM;Gill S;Kahlenberg MS;Quesenberry JT;Thibodeau SN;Smyrk TC;Grothey A;Sinicrope FA;Webb TA;Farr GH Jr;Pockaj BA;Berenberg JL;Mooney M;Sargent DJ;Alberts SR;Alliance for Clinical Trials in Oncology
通讯作者：
Alliance for Clinical Trials in Oncology