Current and emerging therapeutic approaches for colorectal cancer: A comprehensive review

Figure 2 Biomarker-driven therapeutics and cancer stage specific therapeutic strategies. Drugs like tasin-1, statins, and azithromycin specifically target adenomatous polyposis coli (APC). Drugs such as tipifarnib, deltarasin, and cysmethynil target KRAS mutations in colorectal cancer (CRC), and binimetinib and encorafenib target BRAF-V600 mutations in CRC. Vactosertib is a potent and selective transforming growth factor-beta receptor I kinase inhibitor. Small molecule nutlins-3 is an MDM2 antagonist blocking the interaction between MDM2 and p53. Small molecules prima-1/prima-1met convert mutant p53 to an active conformation. There are stage-specific therapies for different stages. For stage 0, colonoscopy and colectomy are recommended. For stage I, colectomy and partial colectomy are recommended. For stage II, partial colectomy, adjuvant chemotherapy, and radiotherapy are recommended. For stage III, chemotherapy includes 5-fluorouracil (5-FU), 5-FU/leucovorin, capecitabine, irinotecan, adjuvant chemotherapy, and combinational chemotherapy [5-FU + leucovorin + oxaliplatin (FOLFOX), 5-FU + leucovorin + irinotecan (FOLFIRI), 5-FU + leucovorin + oxaliplatin + irinotecan (FOLFOXIRI)]. For stage IV, chemotherapy, combinational chemotherapy, and immunotherapy include bevacizumab, ramucirumab, cetuximab, and panitumumab.