结直肠癌(CRC)是美国最致命的恶性肿瘤之一,排在肺之后的第四位,前列腺,和乳腺癌,分别,在一般人群中。这仍然是一种威胁,预计到2035年,发病率将增加一倍以上,特别是在不发达国家。这篇综述旨在提供一些关于疾病进展的见解,目前可用的治疗方案及其挑战,和未来的前景。搜索是在大学在线图书馆的PubMed搜索引擎中进行的。关键词是\"结直肠癌\"和\"疾病过程\"或\"疾病机制\"或\"目前的治疗\"或\"前景\"。选择标准是主要在2013年至2023年期间发表的原创文章。摘要,书籍和文件,和审查/系统审查被过滤掉。在归还的49万件文章中,只有大约800个符合初步选择标准,详细审查了200个,但191符合最终选择标准。由于交叉引用,使用了51篇其他文章。虽然最近被认为是一种生活方式疾病,CRC发病率在低的国家似乎正在上升,中低,和中等社会人口指数。CRC可以影响结肠和直肠的所有部分,但如果是右侧的,则更致命,疾病结局较差。疾病进展通常需要7-10年,并且可以无症状,使早期检测和诊断变得困难。CRC肿瘤微环境由不同类型的细胞相互作用组成,以促进肿瘤细胞的生长和增殖。在结直肠癌的治疗方面已经取得了显著的进展。值得注意的方法包括手术,化疗,放射治疗,还有冷冻疗法.化疗,包括5-氟尿嘧啶,伊立替康,奥沙利铂,和亚叶酸,在已诊断为晚期的CRC的管理中发挥重要作用.FDA已批准两类单克隆抗体疗法用于治疗结直肠癌:血管内皮生长因子(VEGF)抑制剂,例如,贝伐单抗(阿瓦斯丁®),和表皮生长因子受体(EGFR)抑制剂,例如,西妥昔单抗(Erbitux®)和帕尼单抗(Verbitix®)。然而,这些治疗方法仍然存在许多重大问题,主要是脱靶效应,毒副作用,以及相关的小分子药物的治疗失败和mAb疗法的功效的快速丧失。其他新的交付策略仍在继续研究,包括基于配体的CRC细胞靶向。
Colorectal cancer (CRC) is one of the deadliest malignancies in the US, ranking fourth after lung, prostate, and breast cancers, respectively, in general populations. It continues to be a menace, and the incidence has been projected to more than double by 2035, especially in underdeveloped countries. This review seeks to provide some insights into the disease progression, currently available treatment options and their challenges, and future perspectives. Searches were conducted in the PubMed search engine in the university\'s online library. The keywords were \"Colorectal Cancer\" AND \"disease process\" OR \"disease mechanisms\" OR \"Current Treatment\" OR \"Prospects\". Selection criteria were original articles published primarily during the period of 2013 through 2023. Abstracts, books and documents, and reviews/systematic reviews were filtered out. Of over 490 thousand articles returned, only about 800 met preliminary selection criteria, 200 were reviewed in detail, but 191 met final selection criteria. Fifty-one other articles were used due to cross-referencing. Although recently considered a disease of lifestyle, CRC incidence appears to be rising in countries with low, low-medium, and medium social demographic indices. CRC can affect all parts of the colon and rectum but is more fatal with poor disease outcomes when it is right-sided. The disease progression usually takes between 7-10 years and can be asymptomatic, making early detection and diagnosis difficult. The CRC tumor microenvironment is made up of different types of cells interacting with each other to promote the growth and proliferation of the tumor cells. Significant advancement has been made in the treatment of colorectal cancer. Notable approaches include surgery, chemotherapy, radiation therapy, and cryotherapy. Chemotherapy, including 5-fluorouracil, irinotecan, oxaliplatin, and leucovorin, plays a significant role in the management of CRC that has been diagnosed at advanced stages. Two classes of monoclonal antibody therapies have been approved by the FDA for the treatment of colorectal cancer: the vascular endothelial growth factor (VEGF) inhibitor, e.g., bevacizumab (Avastin®), and the epidermal growth factor receptor (EGFR) inhibitor, e.g., cetuximab (Erbitux®) and panitumumab (Verbitix®). However, many significant problems are still being experienced with these treatments, mainly off-target effects, toxic side effects, and the associated therapeutic failures of small molecular drugs and the rapid loss of efficacy of mAb therapies. Other novel delivery strategies continue to be investigated, including ligand-based targeting of CRC cells.