Progressive and Focused Chemotherapy Approaches for Metastatic Colorectal Cancer
Niladri Shekhar Dey* and Rahul Kundu
ABSTRACT
Colorectal cancer is a widespread malignant tumour, ranking as the third most frequently diagnosed cancer and the second primary cause of death worldwide. Surgery or surgery along with radiotherapy and or chemotherapy for individuals with metastatic CRC (mCRC) were considered the main treatment methods until the early 2000s, when targeted therapies like cetuximab and bevacizumab came into play. The use of targeted treatments in healthcare environments has significantly improved patient survival rates. Up to now, the advancement of different kinds of targeted treatments has opened up new prospects and revealed new options for managing mCRC. Therapeutic strategies are continually updated to determine the most suitable targeted drugs informed by the results of current clinical studies. Despite advancements in these therapies, resistance remains a significant challenge, often leading to treatment failure, reduced progression-free survival, and cancer recurrence. Resistance mechanisms in CRC are intricate, involving genetic alterations, epigenetic changes, tumour heterogeneity, and the tumour microenvironment. Moreover, a considerable number of patients face relapses following these therapies. Consequently, it is crucial to explore more efficient treatment alternatives for CRC patients. Immunotherapy, an emerging field in oncology, represents a novel treatment approach that harnesses the body’s immune system to combat cancer cells. The primary advantage of immunotherapy is its capacity to target cancer cells directly while limiting damage to healthy cells. Its recent application as a neoadjuvant therapy shows significant potential to transform the treatment landscape for both primary and metastatic CRC. Immune-modulation strategies have emerged as a promising new therapy to reduce this recurrence rate while minimizing undesirable systemic side effects. This review examines the microenvironment and the immunosuppressive conditions of tumour progression. It highlights the latest research advances in immunotherapy for colorectal metastasis and acknowledges immunotherapy as a promising treatment option with a hopeful future in clinical practice
