Leowattana W, Leowattana P, Leowattana T. Systemic treatment for metastatic colorectal cancer. World J Gastroenterol 2023; 29(10): 1569-1588 [PMID: 36970592 DOI: 10.3748/wjg.v29.i10.1569]
Corresponding Author of This Article
Wattana Leowattana, BMed, MD, MSc, PhD, Full Professor, Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Tawithep Leowattana, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Thailand
Author contributions: Leowattana W wrote the paper; Leowattana T and Leowattana P collected the data.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wattana Leowattana, BMed, MD, MSc, PhD, Full Professor, Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Bangkok 10400, Thailand. wattana.leo@mahidol.ac.th
Received: November 29, 2022 Peer-review started: November 29, 2022 First decision: February 8, 2023 Revised: February 16, 2023 Accepted: February 27, 2023 Article in press: February 27, 2023 Published online: March 14, 2023 Processing time: 101 Days and 2.9 Hours
Core Tip
Core Tip: Advances in the molecular profiling of metastatic colorectal cancer allow treatment to be tailored to the biologic characteristics of the tumor for certain patient subgroups. Although cures are still rare, more people can expect to live longer. Genomic profiling enables therapy selection, allowing more individuals to benefit while exposing fewer to the harm of ineffective medicines. An important component in determining treatment results is the choice of an effective first-line therapy, which should consider both clinical considerations and molecular indicators. The systemic treatments used in the first-line regimen determine the second-line regimen. Third-line therapy, which includes epithelial growth factor receptor inhibitors for patients with rat sarcoma virus wild-type, should consider molecular profiling. Patients with high microsatellite instability illnesses may be candidates for immunotherapy with pembrolizumab or nivolumab plus ipilimumab.
