Chinese General Practice ›› 2025, Vol. 28 ›› Issue (14): 1689-1693.DOI: 10.12114/j.issn.1007-9572.2024.0379
Special Issue: 指南/共识最新文章合辑
• Guidelines Interpretation • Previous Articles Next Articles
Received:
2024-07-16
Revised:
2024-09-18
Published:
2025-05-15
Online:
2025-03-06
Contact:
CHEN Min
通讯作者:
陈敏
作者简介:
作者贡献:
夏雨菡负责文章的构思与论文撰写;卓肖、曹沁涵负责文献资料的收集与整理;廖星雨负责原始指南翻译;罗国樑负责论文修订;唐太春负责文章的质量控制及审校;陈敏对文章整体负责,监督管理。
基金资助:
CLC Number:
标志物 | 发生率 | 意义 |
---|---|---|
MSI/MMR | 总体发生率约为15%,在晚期结直肠癌中约占5% | MSI-H/dMMR结肠癌患者对免疫检查点抑制剂(如PD-1抑制剂)反应较好,特别是在转移性结肠癌的治疗中,通常对5-FU为基础的常规化疗方案反应较差,因此需要个体化的治疗方案 |
HER-2 | 总体发生率约为5% | HER-2阳性结肠癌患者可接受特定HER-2靶向治疗,如抗HER-2的单克隆抗体(例如德曲妥珠单抗)和酪氨酸激酶抑制剂 |
BRAF | 总体发生率为8%~12%,在MSI-H结肠癌患者中发生率为30%~50%,在MSS结肠癌患者中为5%~8% | BRAF突变患者采用BRAF抑制剂靶向治疗。在转移性结肠癌中,组合疗法(如BRAF抑制剂与MEK抑制剂联合)显示出更好的疗效BRAF V600E突变患者采用BRAF抑制剂与抗EGFR药物(如西妥昔单抗)和MEK抑制剂(如曲美替尼)联合使用效果更好 |
POLE/POLD1 | POLE突变发生率为1%~2%,POLD1突变为0.5%~1% | POLE/POLD1突变的结肠癌患者可能对免疫检查点抑制剂有更好的反应,通常预后较好 |
NTRK | 总体发生率一般在1%以下 | 对于NTRK基因融合阳性的患者,使用TRK抑制剂治疗可改善预后,提高生活质量和生存率 |
Table 1 Biomarkers for systemic therapy
标志物 | 发生率 | 意义 |
---|---|---|
MSI/MMR | 总体发生率约为15%,在晚期结直肠癌中约占5% | MSI-H/dMMR结肠癌患者对免疫检查点抑制剂(如PD-1抑制剂)反应较好,特别是在转移性结肠癌的治疗中,通常对5-FU为基础的常规化疗方案反应较差,因此需要个体化的治疗方案 |
HER-2 | 总体发生率约为5% | HER-2阳性结肠癌患者可接受特定HER-2靶向治疗,如抗HER-2的单克隆抗体(例如德曲妥珠单抗)和酪氨酸激酶抑制剂 |
BRAF | 总体发生率为8%~12%,在MSI-H结肠癌患者中发生率为30%~50%,在MSS结肠癌患者中为5%~8% | BRAF突变患者采用BRAF抑制剂靶向治疗。在转移性结肠癌中,组合疗法(如BRAF抑制剂与MEK抑制剂联合)显示出更好的疗效BRAF V600E突变患者采用BRAF抑制剂与抗EGFR药物(如西妥昔单抗)和MEK抑制剂(如曲美替尼)联合使用效果更好 |
POLE/POLD1 | POLE突变发生率为1%~2%,POLD1突变为0.5%~1% | POLE/POLD1突变的结肠癌患者可能对免疫检查点抑制剂有更好的反应,通常预后较好 |
NTRK | 总体发生率一般在1%以下 | 对于NTRK基因融合阳性的患者,使用TRK抑制剂治疗可改善预后,提高生活质量和生存率 |
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