Thema 2019 NCCN Annua Conventus dilatare probat biomaro ut accuratam curationem cancri ac novas mutationes cancri colorectalis (CRC) guidelines dirigat. V annorum pretium superessentiae cancri colorectalis tantum 5% est, et renovatum curationis consilium normas curationis NCCN expectatur ut superstes meliores fiant.
Currently, the FDA has approved a variety of drugs to treat colorectal cancer, of which only four are related to genetic mutations, and biomarkers need to be tested. The 2019 update of NCCN treatment guidelines for colorectal cancer adds treatment methods based on detection of biomarkers, including EGFR, MSI-H / dMMR, BRAF + MEK, and NTRK fusion targets.
Lets 'take a vultus in propria notitia gravibus et magni momenti updates:
+ mFOLFOXIRI EGFR
Based on the phase II phase VOLFI trial, mFOLFOXIRI (fluorouracil + leucovorin + oxaliplatin + irinotecan) plus panitumumab for the EGFR inhibitor, for patients with unresectable metastatic colorectal cancer, these The patient’s genetic test must be: KRAS / NRAS / BRAF wild type and only the left tuberculum praesens est.
VOLFI in iudicium, cum aegris XCVI RAS, ferox genus metastatic colorectal cancer sunt assignata passim mFOLFOXIRI combined per panitumumab (LXIII = n) nec solum mFOLFOXIRI (XXXIII = n) in a II: I Ratio. Quod combined per panitumumab coetus effective cum 96% rate of, cum solus esset mFOLFOXIRI 63%.
MSI DVD / MMR
Etsi microsatellites instabilitas (MSI) et reparatio mismatch (MMR) hereditaria plerumque non sunt, hoc tumores Lynch syndrome inductos non excludit, qui in 1% of BRAF V600E carcinomata colorectalia inemuntur. Si historiae familiae fortis est, experimentum geneticae debet gerere.
Rata et tardus ad usum guidelines indicant deprehendere ex genes praesentem in quattuor mutant Lynch syndrome: MLH1, MSH2, et MSH6 PMS2.
In NCCN provecto vel metastatico cancri colorectalis curationis lineamenta primitiva immunotherapy options for patients with MSI-H and dMMR are nivolumab (nivolumab, Opdivo) or pembrolizumab (pembrolizumab, Keytruda), or nivolumab and ipilimumab (Iraq Combined therapy with Pitimab, Yervoy). These recommendations are category 2B recommendations and apply to patients who are not suitable for a combination cytotoxic chemotherapy regimen. These immunotherapy drug options are also listed in the guidelines as second- and third-line treatment recommendations for dMMR / MSI-H patients.
Nam NTRK
Larotrectinib (Larotinib, Vitrakvi) nunc est secunda acies, cum aegris metastatic colorectal cancer curatio optio. Qui patiens est scriptor geneticae opus est test est positivum deprehendere NTRK gene locum commixtio. Medicamento investigationis notitia orci in erat published in MMXVIII in Nova Anglia Acta Medicine.
Ideo MMXVIII in November, in FDA probata usum larotinib pro treatment of adult pediatric aegros et solidum secundis inflata notis et similitudines anorum. Quamdiu habet NTRK patientes estote et gene fusione non resistente mutationem acquiritur nota est, ut in morbum quem metastasized et resection quae manu redditur, periculo mortis asperae consequuntur, non est consilium et curatio res aliter proficere inciderunt, et post curatio.
In orci iudicium hoc plenus cancer, colorectal cancer metastatic IV aegris cum scriberentur, et respondit, bene patientes estote I.
Nam et BRAF MEK
In hoc update de NCCN guidelines duo recta-secundum hoc biomarker combination therapies have been added, nimirum:
(I) dabrafenib (dalafinib, Tafinlar: BRAF) + trametinib (trametinib, Mekinist: MEK), combined per cetuximab aut panitumumab (EGFR Klon);
(2) Encorafenib (Braftovi; BRAF) plus binmetinib (Mektovi; MEK) plus cetuximab or panitumumab.
quod encorafenib / binimetinib and EGFR inhibitor treatment regimens are supported by data from the introduction of phase III BEACON trials. In 30 patients with metastatic colorectal cancer with BRAF V600E mutation, combined treatment with encorafenib / binimetinib plus cetuximab was followed up for 18.2 months, with an estimated overall survival of 15.3 months. According to local evaluation results, the combined The effective rate of treatment was 48%, and 3 patients achieved complete remission.
Haec renovatio NCCN lineamenta cancri colorectalis iterum confirmat munus magni ponderis geneticae probationis in curatione cancri. Cum una optione plus curatio, plus spei est! Amici Cancer dubitare debet de statu probationis geneticae. Bonus nuntius est quod tam multi probati sunt medicamenta iaculis colorectalis in cancro. Quaeso fove quod in manibus tuis est.
