基因突变与结直肠癌靶向治疗的新进展

New progress in understanding implications of gene mutations for targeted therapies in colorectal cancer

KRAS基因突变作为表皮生长因子受体(epidermal growth factor receptor,EGFR)单抗疗效预测指标的发现,给转移性结直肠癌(metastatic colorectal cancer,mCRC)的治疗带来了巨大的改变.然而,结直肠癌(colorectal cancer,CRC)的发生涉及到多个癌基因、抑癌基因和信号传导通路的改变,而不同的信号传导通路之间存在着千丝万缕的联系,形成了复杂的信号传导网络.如何寻找使用抗EGFR单抗的适合人群,从而避免不必要的不良反应和无效治疗是目前研究的热点.本文就目前国内外研究较多的预测抗EGFR单抗疗效的生物靶标及相应对策进行综述.

The discovery of mutant KRAS as a predictor of resistance to epidermal growth-factor receptor （EGFR） monoclonal antibodies has brought a major change to the treatment of metastatic colorectal cancer. However, changes in multiple oncogenes, tumor suppressor genes and signal transduction pathways occur in colorectal cancer, and there are inextricable relationships among different signal transduction pathways. In order to avoid unnecessary toxicity and invalid expense, how to select patients appropriate for this therapy has become a hot spot of current research. The purpose of this review is to discuss some biomarkers which may predict efficacy of anti-EGFR monoclonal antibody therapy and corresponding strategies.