Targeted therapy of Colorectal cancer

Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer death worldwide. Colorectal cancer (CRC) develops from epithelial cells in the colon or rectum. The ۵-year survival rate for localized CRC is approximately ۶۵%, but this drops to ۱۵% for metastatic CRC, highlighting the need for effective therapeutic strategies. For decades, surgery, chemotherapy, and radiotherapy have been the mainstay of treatment, but targeted therapy appears to be a promising treatment. Targeted therapies include drugs that block specific molecules involved in cancer cell growth. Targeted therapies primarily include monoclonal antibodies and small molecule inhibitors that specifically target pathways involved in tumorigenesis. Chemotherapy regimens like FOLFOX (fluorouracil, leucovorin, and oxaliplatin) and FOLFIRI (fluorouracil, leucovorin, and irinotecan) are often used in combination with targeted therapies. New combinations and innovative drugs are being investigated in clinical trials to improve treatment efficacy and patient survival. This review outlines the latest advancements in targeted therapies and immunotherapy approaches, highlighting their mechanisms, efficacy, and clinical implications. Result AND Discussion: Targeted therapy drugs can be classified into two main categories: small molecules and macromolecules (e.g., monoclonal antibodies). Angiogenesis, the creation of networks of blood vessels, supports the growth and survival of cancer cells and facilitates the dissemination of metastases. Vascular endothelial growth factor (VEGF), platelet-derived growth factor, and fibroblast growth factor are a few examples of the pro- and anti-angiogenic factors and receptors that mediate it. Epidermal Growth Factor Receptor (EGFR) belongs to the ErbB family of receptor tyrosine kinases, and ligand binding to its extracellular domain leads to phosphorylation of the tyrosine kinase domain, which activates signaling pathways for cell proliferation, angiogenesis, migration, survival, and adhesion. VEGF and EGFR serve as meaningful targets in the treatment of colorectal cancer metastases because cancer cells depend on these pathways. Angiogenesis inhibitors like bevacizumab and ramucirumab are among the macromolecules that target the VEGF pathway to disrupt tumor blood vessel formation and growth. Bevacizumab combined with chemotherapy has become a standard first-line treatment for metastatic colorectal cancer. Despite the many applications of monoclonal antibodies, small-molecule drugs have received much attention due to their improved pharmacokinetic properties and cost-effectiveness. For example, small molecules such as regorafenib with good efficacy in the treatment of metastatic colorectal cancer is a multikinase inhibitor that target several kinases involved in angiogenesis, oncogenesis, and the tumor microenvironment. Targeted therapy has been shown to significantly improve overall survival rates in clinical trials. In conclusion, the landscape of biomarker-guided target therapy for colorectal cancer is undergoing rapid evolution, with significant potential for the development of personalized treatment approaches. However, more research is needed to understand how biomarkers interact and to find better therapeutic strategies.

کلیدواژه ها:

Colorectal cancer ، Monoclonal Antibody ، Therapeutic protein ، Targeted therapy