Advances in the treatment of colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DUAN Jiayu ^1,2 , TANG Yuanling ^1,2 , GU Shiyuan ^1,2 ,  WANG Xin ^1,2

1. Department of Abdominal Cancer, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Xin, Email: wangxin@wchscu.edu.cn

Keywords：

colorectal cancer; multidisciplinary comprehensive treatment; neoadjuvant chemoradiotherapy; immunotherapy; target therapy

DOI：

10.7507/1007-9424.202404039

Video：

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Abstract Full text Figures/Tables Video References Cited by

Colorectal cancer (CRC) is a prevalent malignant tumor worldwide. With the development of medical technology, the treatment strategies of CRC are constantly improving and updating. The aim of treating CRC is not only to improve outcomes but also to maintain organ function and enhance quality of life. For patients with locally advanced rectal cancer, a variety of neoadjuvant treatment options are available and it is important to choose an individualized strategy. Immune checkpoint inhibitors have become an important part of the first- and posterior-line treatment for patients with deficient mis-match repair or high microsatellite instability colorectal cancer in metastatic colorectal cancer, and the emergence of new targets and drugs has further improved treatment efficacy and long-term survival. Furthermore, an increasing number of studies have confirmed the potential the value of predicting and guiding treatment for minimal residual disease. This article summarizes the representative research results, guideline updates, and important academic conference reports in the field of colorectal cancer.

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond), 2021, 41(10): 1037-1048.
3.	Aschele C, Glynne-Jones R. Selecting a TNT schedule in locally advanced rectal cancer: can we predict who actually benefits? Cancers (Basel), 2023, 15(9): 2567.
4.	Hong YS, Kim SY, Lee JS, et al. Oxaliplatin-based adjuvant chemotherapy for rectal cancer after preoperative chemoradiotherapy (ADORE): long-term results of a randomized controlled trial. J Clin Oncol, 2019, 37(33): 3111-3123.
5.	Roselló S, Papaccio F, Roda D, et al. The role of chemotherapy in localized and locally advanced rectal cancer: a systematic revision. Cancer Treat Rev, 2018 Feb: 63: 156-171.
6.	Erlandsson J, Lörinc E, Ahlberg M, et al. Tumour regression after radiotherapy for rectal cancer - results from the randomised Stockholm Ⅲ trial. Radiother Oncol, 2019, 135: 178-186.
7.	Erlandsson J, Holm T, Pettersson D, et al. Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm Ⅲ): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial. Lancet Oncol, 2017, 18(3): 336-346.
8.	Radu C, Berglund A, Påhlman L, et al. Short-course preoperative radiotherapy with delayed surgery in rectal cancer - a retrospective study. Radiother Oncol, 2008, 87(3): 343-349.
9.	Bahadoer RR, Dijkstra EA, van Etten B, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol, 2021, 22(1): 29-42.
10.	Conroy T, Bosset JF, Etienne PL, et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol, 2021, 22(5): 702-715.
11.	Benson AB, Venook AP, Al-Hawary MM, et al. Rectal cancer, version 2. 2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(10): 1139-1167.
12.	Papaccio F, Roselló S, Huerta M, et al. Neoadjuvant chemotherapy in locally advanced rectal cancer. Cancers (Basel), 2020, 12(12): 3611.
13.	Michael-Robinson JM, Biemer-Hüttmann A, Purdie DM, et al. Tumour infiltrating lymphocytes and apoptosis are independent features in colorectal cancer stratified according to microsatellite instability status. Gut, 2001, 48(3): 360-366.
14.	Le DT, Durham JN, Smith KN, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science, 2017, 357(6349): 409-413.
15.	Cercek A, Lumish M, Sinopoli J, et al. PD-1 blockade in mismatch repair-deficient, locally advanced rectal cancer. N Engl J Med, 2022, 386(25): 2363-2376.
16.	Chen G, Jin Y, Guan WL, et al. Neoadjuvant PD-1 blockade with sintilimab in mismatch-repair deficient, locally advanced rectal cancer: an open-label, single-centre phase 2 study. Lancet Gastroenterol Hepatol, 2023, 8(5): 422-431.
17.	Yu JH, Liao LE, Xiao BY, et al. Long-term outcomes of dMMR/MSI-H rectal cancer treated with anti-PD-1-based immunotherapy as curative-intent treatment. J Natl Compr Canc Netw, 2024, 22(3): e237096.
18.	Bando H, Tsukada Y, Inamori K, et al. Preoperative chemoradiotherapy plus nivolumab before surgery in patients with microsatellite stable and microsatellite instability-high locally advanced rectal cancer. Clin Cancer Res, 2022, 28(6): 1136-1146.
19.	Wang Y, Shen L, Wan J, et al. Neoadjuvant chemoradiotherapy combined with immunotherapy for locally advanced rectal cancer: a new era for anal preservation. Front Immunol, 2022, 13: 1067036.
20.	Zhang T, Tao K, Lin Z, et al. LBA25 Neoadjuvant short-course radiotherapy followed by camrelizumab plus chemotherapy versus long-course chemoradiotherapy followed by chemotherapy in locally advanced rectal cancer: a randomized phase Ⅲ trial (UNION). Ann Oncol, 2023, 34 (SUPPLEMENT 2): S1266-S1267.
21.	Dovedi SJ, Adlard AL, Lipowska-Bhalla G, et al. Acquired resistance to fractionated radiotherapy can be overcome by concurrent PD-L1 blockade. Cancer Res, 2014, 74(19): 5458-5468.
22.	Brix N, Tiefenthaller A, Anders H, et al. Abscopal, immunological effects of radiotherapy: narrowing the gap between clinical and preclinical experiences. Immunol Rev, 2017, 280(1): 249-279.
23.	Postow MA, Callahan MK, Barker CA, et al. Immunologic correlates of the abscopal effect in a patient with melanoma. N Engl J Med, 2012, 366(10): 925-931.
24.	Schrag D, Shi Q, Weiser MR, et al. Preoperative treatment of locally advanced rectal cancer. N Engl J Med, 2023, 389(4): 322-334.
25.	Schrag D, Shi Q, Weiser M R, et al. PROSPECT: a randomized phase Ⅲ trial of neoadjuvant chemoradiation versus neoadjuvant FOLFOX chemotherapy with selective use of chemoradiation, followed by total mesorectal excision (TME) for treatment of locally advanced rectal cancer (LARC) (Alliance N1048). J Clin Oncol, 2023, 41(17_suppl): LBA2.
26.	van der Valk MJM, Hilling DE, Bastiaannet E, et al. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet, 2018, 391(10139): 2537-2545.
27.	Maas M, Beets-Tan RG, Lambregts DM, et al. Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer. J Clin Oncol, 2011, 29(35): 4633-4640.
28.	Glynne-Jones R, Wallace M, Livingstone JI, et al. Complete clinical response after preoperative chemoradiation in rectal cancer: is a "wait and see" policy justified? Dis Colon Rectum, 2008, 51(1): 10-19, 19-20.
29.	中国直肠癌新辅助治疗后等待观察数据库研究协作组, 中国医师协会外科医师分会中国医师协会肛肠医师分会, 中华医学会外科学分会结直肠外科学组, 等. 直肠癌新辅助治疗后等待观察策略专家共识 (2020版). 中华胃肠外科杂志, 2020, 23(1): 1-9.
30.	Benson AB, Venook AP, Al-Hawary MM, et al. Rectal cancer, version 2. 2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2018, 16(7): 874-901.
31.	André T, Shiu KK, Kim TW, et al. Pembrolizumab in microsatellite-instability-high advanced colorectal cancer. N Engl J Med, 2020, 383(23): 2207-2218.
32.	Andre T, Elez E, Cutsem E V, et al. Nivolumab (NIVO) plus ipilimumab (IPI) vs chemotherapy (chemo) as first-line (1L) treatment for microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC): first results of the CheckMate 8HW study. J Clin Oncol, 2024, 42(3_suppl): LBA768.
33.	Wan PT, Garnett MJ, Roe SM, et al. Mechanism of activation of the RAF-ERK signaling pathway by oncogenic mutations of B-RAF. Cell, 2004, 116(6): 855-867.
34.	Loupakis F, Cremolini C, Masi G, et al. Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer. N Engl J Med, 2014, 371(17): 1609-1618.
35.	Van Cutsem E, Huijberts S, Grothey A, et al. Binimetinib, encorafenib, and cetuximab triplet therapy for patients with BRAF V600E-mutant metastatic colorectal cancer: safety lead-in results from the phase Ⅲ BEACON colorectal cancer study. J Clin Oncol, 2019, 37(17): 1460-1469.
36.	Van Cutsem E, Taieb J, Yaeger R, et al. ANCHOR CRC: results from a single-arm, phase Ⅱ study of encorafenib plus binimetinib and cetuximab in previously untreated BRAFV600E-mutant metastatic colorectal cancer. J Clin Oncol, 2023, 41(14): 2628-2637.
37.	Bertotti A, Migliardi G, Galimi F, et al. A molecularly annotated platform of patient-derived xenografts ("xenopatients") identifies HER2 as an effective therapeutic target in cetuximab-resistant colorectal cancer. Cancer Discov, 2011, 1(6): 508-523.
38.	Sartore-Bianchi A, Trusolino L, Martino C, et al. Dual-targeted therapy with trastuzumab and lapatinib in treatment-refractory, KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer (HERACLES): a proof-of-concept, multicentre, open-label, phase 2 trial. Lancet Oncol, 2016, 17(6): 738-746.
39.	Benson AB, Venook AP, Al-Hawary MM, et al. Colon cancer, version 2. 2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2021, 19(3): 329-359.
40.	Siena S, Di Bartolomeo M, Raghav K, et al. Trastuzumab deruxtecan (DS-8201) in patients with HER2-expressing metastatic colorectal cancer (DESTINY-CRC01): a multicentre, open-label, phase 2 trial. Lancet Oncol, 2021, 22(6): 779-789.
41.	Karapetis CS, Khambata-Ford S, Jonker DJ, et al. K-ras mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med, 2008, 359(17): 1757-1765.
42.	Hong DS, Fakih MG, Strickler JH, et al. KRASG12C inhibition with sotorasib in advanced solid tumors. N Engl J Med, 2020, 383(13): 1207-1217.
43.	Xu RH, Xu Y, Yan D, et al. 550O safety and efficacy of D-1553 in combination with cetuximab in KRAS G12C mutated colorectal cancer (CRC): a phase Ⅱ study. Ann Oncol, 2023, 34: S410-S411.
44.	Dienstmann R, Connor K, Byrne AT, et al. Precision therapy in RAS mutant colorectal cancer. Gastroenterology, 2020, 158(4): 806-811.
45.	Zhou C, Li W, Song Z, et al. LBA33 A first-in-human phase Ⅰ study of a novel KRAS G12D inhibitor HRS-4642 in patients with advanced solid tumors harboring KRAS G12D mutation. Ann Oncol, 2023, 34: S1273.
46.	Tie J, Cohen JD, Lahouel K, et al. Circulating tumor DNA analysis guiding adjuvant therapy in stage Ⅱ colon cancer. N Engl J Med, 2022, 386(24): 2261-2272.
47.	Yukami H, Nakamura Y, Mishima S, et al. Circulating tumor DNA (ctDNA) dynamics in patients with colorectal cancer (CRC) with molecular residual disease: updated analysis from GALAXY study in the CIRCULATE-JAPAN. J Clin Oncol, 2024, 42(3_suppl): 6.
48.	Lonardi S, Pietrantonio F, Tarazona Llavero N, et al. LBA28 the PEGASUS trial: post-surgical liquid biopsy-guided treatment of stage Ⅲ and high-risk stage Ⅱ colon cancer patients. Ann Oncol, 2023, 34: S1268-S1269.
49.	van Rees JM, Wullaert L, Grüter AAJ, et al. Circulating tumour DNA as biomarker for rectal cancer: a systematic review and meta-analyses. Front Oncol, 2023, 13: 1083285.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Qiu H, Cao S, Xu R. Cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with the United States and United Kingdom based on the global epidemiological data released in 2020. Cancer Commun (Lond), 2021, 41(10): 1037-1048.
3. Aschele C, Glynne-Jones R. Selecting a TNT schedule in locally advanced rectal cancer: can we predict who actually benefits? Cancers (Basel), 2023, 15(9): 2567.
4. Hong YS, Kim SY, Lee JS, et al. Oxaliplatin-based adjuvant chemotherapy for rectal cancer after preoperative chemoradiotherapy (ADORE): long-term results of a randomized controlled trial. J Clin Oncol, 2019, 37(33): 3111-3123.
5. Roselló S, Papaccio F, Roda D, et al. The role of chemotherapy in localized and locally advanced rectal cancer: a systematic revision. Cancer Treat Rev, 2018 Feb: 63: 156-171.
6. Erlandsson J, Lörinc E, Ahlberg M, et al. Tumour regression after radiotherapy for rectal cancer - results from the randomised Stockholm Ⅲ trial. Radiother Oncol, 2019, 135: 178-186.
7. Erlandsson J, Holm T, Pettersson D, et al. Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm Ⅲ): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial. Lancet Oncol, 2017, 18(3): 336-346.
8. Radu C, Berglund A, Påhlman L, et al. Short-course preoperative radiotherapy with delayed surgery in rectal cancer - a retrospective study. Radiother Oncol, 2008, 87(3): 343-349.
9. Bahadoer RR, Dijkstra EA, van Etten B, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial. Lancet Oncol, 2021, 22(1): 29-42.
10. Conroy T, Bosset JF, Etienne PL, et al. Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol, 2021, 22(5): 702-715.
11. Benson AB, Venook AP, Al-Hawary MM, et al. Rectal cancer, version 2. 2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(10): 1139-1167.
12. Papaccio F, Roselló S, Huerta M, et al. Neoadjuvant chemotherapy in locally advanced rectal cancer. Cancers (Basel), 2020, 12(12): 3611.
13. Michael-Robinson JM, Biemer-Hüttmann A, Purdie DM, et al. Tumour infiltrating lymphocytes and apoptosis are independent features in colorectal cancer stratified according to microsatellite instability status. Gut, 2001, 48(3): 360-366.
14. Le DT, Durham JN, Smith KN, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science, 2017, 357(6349): 409-413.
15. Cercek A, Lumish M, Sinopoli J, et al. PD-1 blockade in mismatch repair-deficient, locally advanced rectal cancer. N Engl J Med, 2022, 386(25): 2363-2376.
16. Chen G, Jin Y, Guan WL, et al. Neoadjuvant PD-1 blockade with sintilimab in mismatch-repair deficient, locally advanced rectal cancer: an open-label, single-centre phase 2 study. Lancet Gastroenterol Hepatol, 2023, 8(5): 422-431.
17. Yu JH, Liao LE, Xiao BY, et al. Long-term outcomes of dMMR/MSI-H rectal cancer treated with anti-PD-1-based immunotherapy as curative-intent treatment. J Natl Compr Canc Netw, 2024, 22(3): e237096.
18. Bando H, Tsukada Y, Inamori K, et al. Preoperative chemoradiotherapy plus nivolumab before surgery in patients with microsatellite stable and microsatellite instability-high locally advanced rectal cancer. Clin Cancer Res, 2022, 28(6): 1136-1146.
19. Wang Y, Shen L, Wan J, et al. Neoadjuvant chemoradiotherapy combined with immunotherapy for locally advanced rectal cancer: a new era for anal preservation. Front Immunol, 2022, 13: 1067036.
20. Zhang T, Tao K, Lin Z, et al. LBA25 Neoadjuvant short-course radiotherapy followed by camrelizumab plus chemotherapy versus long-course chemoradiotherapy followed by chemotherapy in locally advanced rectal cancer: a randomized phase Ⅲ trial (UNION). Ann Oncol, 2023, 34 (SUPPLEMENT 2): S1266-S1267.
21. Dovedi SJ, Adlard AL, Lipowska-Bhalla G, et al. Acquired resistance to fractionated radiotherapy can be overcome by concurrent PD-L1 blockade. Cancer Res, 2014, 74(19): 5458-5468.
22. Brix N, Tiefenthaller A, Anders H, et al. Abscopal, immunological effects of radiotherapy: narrowing the gap between clinical and preclinical experiences. Immunol Rev, 2017, 280(1): 249-279.
23. Postow MA, Callahan MK, Barker CA, et al. Immunologic correlates of the abscopal effect in a patient with melanoma. N Engl J Med, 2012, 366(10): 925-931.
24. Schrag D, Shi Q, Weiser MR, et al. Preoperative treatment of locally advanced rectal cancer. N Engl J Med, 2023, 389(4): 322-334.
25. Schrag D, Shi Q, Weiser M R, et al. PROSPECT: a randomized phase Ⅲ trial of neoadjuvant chemoradiation versus neoadjuvant FOLFOX chemotherapy with selective use of chemoradiation, followed by total mesorectal excision (TME) for treatment of locally advanced rectal cancer (LARC) (Alliance N1048). J Clin Oncol, 2023, 41(17_suppl): LBA2.
26. van der Valk MJM, Hilling DE, Bastiaannet E, et al. Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet, 2018, 391(10139): 2537-2545.
27. Maas M, Beets-Tan RG, Lambregts DM, et al. Wait-and-see policy for clinical complete responders after chemoradiation for rectal cancer. J Clin Oncol, 2011, 29(35): 4633-4640.
28. Glynne-Jones R, Wallace M, Livingstone JI, et al. Complete clinical response after preoperative chemoradiation in rectal cancer: is a "wait and see" policy justified? Dis Colon Rectum, 2008, 51(1): 10-19, 19-20.
29. 中国直肠癌新辅助治疗后等待观察数据库研究协作组, 中国医师协会外科医师分会中国医师协会肛肠医师分会, 中华医学会外科学分会结直肠外科学组, 等. 直肠癌新辅助治疗后等待观察策略专家共识 (2020版). 中华胃肠外科杂志, 2020, 23(1): 1-9.
30. Benson AB, Venook AP, Al-Hawary MM, et al. Rectal cancer, version 2. 2018, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2018, 16(7): 874-901.
31. André T, Shiu KK, Kim TW, et al. Pembrolizumab in microsatellite-instability-high advanced colorectal cancer. N Engl J Med, 2020, 383(23): 2207-2218.
32. Andre T, Elez E, Cutsem E V, et al. Nivolumab (NIVO) plus ipilimumab (IPI) vs chemotherapy (chemo) as first-line (1L) treatment for microsatellite instability-high/mismatch repair-deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC): first results of the CheckMate 8HW study. J Clin Oncol, 2024, 42(3_suppl): LBA768.
33. Wan PT, Garnett MJ, Roe SM, et al. Mechanism of activation of the RAF-ERK signaling pathway by oncogenic mutations of B-RAF. Cell, 2004, 116(6): 855-867.
34. Loupakis F, Cremolini C, Masi G, et al. Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer. N Engl J Med, 2014, 371(17): 1609-1618.
35. Van Cutsem E, Huijberts S, Grothey A, et al. Binimetinib, encorafenib, and cetuximab triplet therapy for patients with BRAF V600E-mutant metastatic colorectal cancer: safety lead-in results from the phase Ⅲ BEACON colorectal cancer study. J Clin Oncol, 2019, 37(17): 1460-1469.
36. Van Cutsem E, Taieb J, Yaeger R, et al. ANCHOR CRC: results from a single-arm, phase Ⅱ study of encorafenib plus binimetinib and cetuximab in previously untreated BRAFV600E-mutant metastatic colorectal cancer. J Clin Oncol, 2023, 41(14): 2628-2637.
37. Bertotti A, Migliardi G, Galimi F, et al. A molecularly annotated platform of patient-derived xenografts ("xenopatients") identifies HER2 as an effective therapeutic target in cetuximab-resistant colorectal cancer. Cancer Discov, 2011, 1(6): 508-523.
38. Sartore-Bianchi A, Trusolino L, Martino C, et al. Dual-targeted therapy with trastuzumab and lapatinib in treatment-refractory, KRAS codon 12/13 wild-type, HER2-positive metastatic colorectal cancer (HERACLES): a proof-of-concept, multicentre, open-label, phase 2 trial. Lancet Oncol, 2016, 17(6): 738-746.
39. Benson AB, Venook AP, Al-Hawary MM, et al. Colon cancer, version 2. 2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2021, 19(3): 329-359.
40. Siena S, Di Bartolomeo M, Raghav K, et al. Trastuzumab deruxtecan (DS-8201) in patients with HER2-expressing metastatic colorectal cancer (DESTINY-CRC01): a multicentre, open-label, phase 2 trial. Lancet Oncol, 2021, 22(6): 779-789.
41. Karapetis CS, Khambata-Ford S, Jonker DJ, et al. K-ras mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med, 2008, 359(17): 1757-1765.
42. Hong DS, Fakih MG, Strickler JH, et al. KRASG12C inhibition with sotorasib in advanced solid tumors. N Engl J Med, 2020, 383(13): 1207-1217.
43. Xu RH, Xu Y, Yan D, et al. 550O safety and efficacy of D-1553 in combination with cetuximab in KRAS G12C mutated colorectal cancer (CRC): a phase Ⅱ study. Ann Oncol, 2023, 34: S410-S411.
44. Dienstmann R, Connor K, Byrne AT, et al. Precision therapy in RAS mutant colorectal cancer. Gastroenterology, 2020, 158(4): 806-811.
45. Zhou C, Li W, Song Z, et al. LBA33 A first-in-human phase Ⅰ study of a novel KRAS G12D inhibitor HRS-4642 in patients with advanced solid tumors harboring KRAS G12D mutation. Ann Oncol, 2023, 34: S1273.
46. Tie J, Cohen JD, Lahouel K, et al. Circulating tumor DNA analysis guiding adjuvant therapy in stage Ⅱ colon cancer. N Engl J Med, 2022, 386(24): 2261-2272.
47. Yukami H, Nakamura Y, Mishima S, et al. Circulating tumor DNA (ctDNA) dynamics in patients with colorectal cancer (CRC) with molecular residual disease: updated analysis from GALAXY study in the CIRCULATE-JAPAN. J Clin Oncol, 2024, 42(3_suppl): 6.
48. Lonardi S, Pietrantonio F, Tarazona Llavero N, et al. LBA28 the PEGASUS trial: post-surgical liquid biopsy-guided treatment of stage Ⅲ and high-risk stage Ⅱ colon cancer patients. Ann Oncol, 2023, 34: S1268-S1269.
49. van Rees JM, Wullaert L, Grüter AAJ, et al. Circulating tumour DNA as biomarker for rectal cancer: a systematic review and meta-analyses. Front Oncol, 2023, 13: 1083285.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Latest ArticlesAdvances in the treatment of colorectal cancer

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