Ewha Med J.  2021 Jan;44(1):11-18. 10.12771/emj.2021.44.1.11.

New Molecular Targeted Therapy of Metastatic Colorectal Cancer

• Jo J

• KMID: 2512406
• DOI: http://doi.org/10.12771/emj.2021.44.1.11

Abstract

Over the past decade, substantial advances have been made in the individualization of therapeutic strategies for metastatic colorectal cancer (mCRC). Treatment strategies have been developed and classified according to their molecular and genetic characteristics based on predictive biomarkers such as microsatellite instability, RAS and BRAF mutations, HER2 amplification, or NTRK fusions. As molecular and genetic predictive tests are routinely performed, new challenges for mCRC treatment strategies are allowed. For patients responding to anti-epithelial growth factor receptor treatments, expanded biomarkers panels enable customized treatment to be selected and the optimal treatment can be determined. Patients with mCRC with the BRAF^V600E mutation who did not have effective targeted treatments have effective therapeutic options. Attractive but rare targets, such as HER2 amplification and NTRK fusions, could be a breakthrough and the use of immune checkpoint inhibitors in patients with mismatch repair deficiency/microsatellite instability is the striking revolution. In this review, we summarize the current landscape of targeted therapies for mCRC patients, with a focus on new developments for epithelial growth factor receptor blockade and emerging biomarkers.

Keyword

Colorectal neoplasms; NTRK; HER2; BRAF; Molecular targeted therapy

Figure

• 

  Fig. 1 Molecular targets in metastatic colorectal cancer. MSI, microsatellite instability; NTRK, neurotrophic tyrosine receptor kinase; HER2, human epidermal growth factor receptor 2; KRAS, Kirsten rat sarcoma viral oncogene homolog; RAS, rat sarcoma viral oncogene homolog; BRAF, B-Raf proto-oncogene, serine/threonine-protein kinase; NRAS, neuroblastoma rat sarcoma viral oncogene homolog.

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