结直肠癌(CRC)是全球男性第三大常见癌症,女性第二大常见癌症。在拉丁美洲和加勒比,死亡率为56%。转移性结直肠癌(mCRC)患者的中位总生存期目前估计为约30个月。通过在治疗和患者管理方面的战略变化,这已经大大改善。与其他经常确定一线治疗方案的转移性癌症相反,mCRC需要特别关注,因为对于每位患者,现有药物的可能组合和不同的持续时间存在争议.每种组合都必须力求有效,并尽可能产生最小的不利影响。而不是给予一线方案,直到肿瘤进展,治疗往往是个性化的。此外,多达60%的结直肠肿瘤被认为是非突变或野生型CRC。在RAS基因家族中没有突变或表皮生长因子受体信号通路中的突变导致抗表皮生长因子受体抗体治疗无效反应。这意味着对其管理的考虑更加复杂。该共识的主要目标是解决mCRC的主要情况,以便为中美洲和加勒比(CAC)地区的这些患者提供最合适的治疗干预。这可以导致更好的临床结果以及姑息患者的生活质量。本文件包括针对mCRC突变和非突变情况的正式专家共识建议,包括同步或异时性疾病,mCRC肝、肺转移的处理,可切除,潜在可切除或不可切除的肿瘤,以及CAC上下文中的局部肿瘤。
Colorectal cancer (CRC) is the third most common cancer in men and the second most common in women worldwide. In Latin America and the Caribbean, it has a mortality of 56%. The median overall survival for patients with metastatic colorectal cancer (mCRC) is currently estimated as ~30 months, which has substantially improved through strategic changes in treatment and in the management of patients. As opposed to other metastatic cancers where first-line regimens are often determined, mCRC requires special attention because there is controversy in the possible combinations of the available drugs and the different periods of duration for each patient. Each combination must seek to be effective and to generate the minimum adverse effects as possible. Instead of giving the first-line regimen until the tumour progresses, treatment is often individualised. Furthermore, up to 60% of colorectal tumours are considered non-mutated or wild-type CRC. Not harbouring mutations in the RAS family of genes or mutations in the signalling pathways of the epidermal growth factor receptor causes a null response to anti-epidermal growth factor receptor antibody therapy, which implies even more complex considerations regarding its management. The primary objective of this
consensus is to address the main scenarios of mCRC in order to warrant the most appropriate therapeutic intervention for these patients in the Central American and the Caribbean (CAC) region. This can lead to better clinical outcomes as well as quality of life for palliative patients. This document includes the formal expert
consensus recommendations for scenarios of mutated and non-mutated mCRC, including synchronous or metachronous disease, management of mCRC with liver and lung metastasis, resectable, potentially resectable or non-resectable tumours and local in the CAC context.