Ante initium articuli, primus vultus ad scientiam.
Intellectus MSI DVD-II, mss, MSI Domino,
-
MSS (microsatellite firmitudo), microsatellite vel stabilitatem procurandam, Laptop MSI comparari, non est obvious MSI.
-
MSI DVD-H (High-microsatellite instabilitatem, microsatellite varietate summus frequency), hoc est, de instabilitatem microsatellite frequency est princeps, altior quam fere XXX%;
-
MSI DVD-L (microsatellite instabilitatem, Low, low frequency microsatellite varietate), hoc est, de instabilitatem low frequency et microsatellite, plerumque minus quam XXX%.
Friends who are concerned about the latest progress in cancer treatment know that the broad-spectrum anticancer drugs pembrolizumab and nivolumab have been approved for the treatment of all solid tumor patients with MSI-H (high microsatellite instability). Especially for colorectal patients, the detection rate of MSI-H is relatively high, so some cancer patients benefit from this type of treatment to prolong survival.
In the NCCN advanced or metastatic colorectal cancer treatment guidelines, the first-line 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 cum aegris unresectable provectus aut secundum locum, aut in morbo succrevit metastatic colorectal cancer qui repugnant duabus saltem priorem systemica chemotherapy, diaetam, XCV% pro eorum posse deprehendere mss MSI DVD-H. Ita, quam ut eligere mss colorectal cancer aegris?
Recently, the IMblaze370 trial was published as a phase III open-label trial, and 363 patients with metastatic colorectal cancer whose genetic test results were MSS were randomly assigned to atezolizumab (atezolizumab) in combination with cobimetinib (cobititib) at 2: 1: 1 Ni, MEK targeted drug) group, attuzumab monotherapy group, regorafenib (regorafenib, multi-target kinase inhibitor) group. Patients with MSS colorectal cancer have historically not responded to immunotherapy.
Eventus hoc studio iterum iterumque confirment, a colorectal cancer aegris, non Respondeo dicendum quod tam in mss immunotherapy (PD-L1) atuzumab medicamento. Mediana cum cobtinib coetus altiore salvos atezumab erat 8.87-7.10 menses mensibus comparari 8.51 et XNUMX, in una mensis atezumab regofenib in coetus, cujuscumque sive fuit sive collegiatas et immunotherapy solum significant salvos non est bonum.
Nam libero salvos media progressum, et tribus mensibus curatio coetus fuisse 1.91, 1.94 menses et menses 2.00 et quod indifferens est. Et certe fuit LXI% rate of gradu 3/4 adversa in compositum Lorem coetus, XXXI% de coetus atuzumab MONOTHERAPY et regofenib LVIII% de coetus.
"Hi praecessi optatum eo spectabant inter fortes biologicum ac mss MSI DVD-II, curatio vehementiusque dicit diversas necessitates inter haec duo genera morbo," dicit Dr. Cathy Eng, a inquisitorem cum University of Texas Anderson Cancer Center.
That is to say, the colorectal cancer patients whose MSS is found by genetic testing do not recommend the choice of immunotherapy, and use other methods instead. At present, the targets and targeted drugs that can be achieved by patients with colorectal cancer are:
-
VEGF: Bevacizumab, Apsip
-
VEGFR: ramucirumab, rigofinib, fruquintinib
-
EGFR: cetuximab, panitumumab
-
PD-1 / PDL-1: pembrolizumab, nivolumab
-
CTLA-IV: Ipilimumab
-
BRAF: Velofini
-
NTRK: Larotinib
Si alterum scopum mutationes sunt correspondentes, eo medicamento Lorem potest targeted correspondentes lectus.
Enim a colorectal cancer aegris, vos potest eligere de chemotherapy vexillum paro-FOLFOXIRI (Fluorouracil leucovorin + + + oxaliplatin irinotecan), quod est compositum ex a et coetus Cytotoxic chemotherapeutic agentium, nam omni populo idoneam.
After drug resistance, the genetic test result is not MSI-H. You can also choose multi-target kinase inhibitors regorafenib (regorafenib, Stivarga) and TAS-102 (trifluridine / tipiracil; Lonsurf).
Cetuximab is also a star drug often selected by colorectal patients, which is a drug that often appears in individualized treatment plans. Evaluation methods include: Is the tumor on the left or right? Does it contain KRAS / NRAS mutations? Before selecting cetuximab or panitumumab, the RAS gene mutation must be considered.
