Abstract：
Colorectal cancer (CRC) is a major cause of cancer-related deaths globally. While treatment advancements have improved survival rates, primarily through targeted therapies based on KRAS, NRAS, and BRAF mutations, personalized treatment strategies for CRC remain limited. Immunotherapy, mainly immune checkpoint blockade, has shown efficacy in various cancers but is effective in only a small subset of patients with CRC with deficient mismatch repair (dMMR) proteins or high microsatellite instability (MSI). Recent research has challenged the notion that CRC is immunologically inert, revealing subsets with high immunogenicity and diverse lymphocytic infiltration. Identifying precise biomarkers beyond dMMR and MSI is crucial to expanding immunotherapy benefits. Hence, exploration has extended to various biomarker sources, such as the tumor microenvironment, genomic markers, and gut microbiota. Recent studies have introduced a novel classification system, consensus molecular subtypes, that aids in identifying patients with CRC with an immunogenic profile. These findings underscore the necessity of moving beyond single biomarkers and toward a comprehensive understanding of the immunological landscape in CRC, facilitating the development of more effective, personalized therapies.
摘要：
结直肠癌（CRC）是全球癌症相关死亡的主要原因。虽然治疗进展提高了生存率，主要通过基于KRAS的靶向治疗，NRAS,和BRAF突变,CRC的个性化治疗策略仍然有限.免疫疗法,主要是免疫检查点封锁，已在各种癌症中显示出疗效，但仅在一小部分具有缺陷错配修复（dMMR）蛋白或高微卫星不稳定性（MSI）的CRC患者中有效。最近的研究挑战了CRC免疫惰性的概念，揭示具有高免疫原性和多样化淋巴细胞浸润的亚群。识别dMMR和MSI以外的精确生物标志物对于扩大免疫治疗益处至关重要。因此，探索已经扩展到各种生物标志物来源，比如肿瘤微环境，基因组标记，和肠道微生物群。最近的研究引入了一种新的分类系统，共有分子亚型，这有助于鉴定具有免疫原性的CRC患者。这些发现强调了超越单一生物标志物和走向全面了解CRC免疫学景观的必要性。促进更有效的发展，个性化治疗。
