The occurrence of bowel cancer is a complex process of multiple genes and multiple steps. Accuracy is to emphasize the detection of genes, proteins and other tests to reflect the biological characteristics of patients and tumors, and judge the prognosis of patients and which ** is more valuable to patients.
For metastatic colorectal cancer, how to choose the right drug is a key problem that plagues it, and at present, genetic testing can guide the accuracy of colorectal cancer, such as: for patients with RAS gene mutations, bevacizumab is not selected instead of cetuximab**; For patients with BRAF gene mutations, a three-agent chemotherapy regimen plus bevacizumab** can be used; For advanced colorectal cancer with deletion of mismatch repair genes, immunization with PD-1 PD-L1 monoclonal antibody**, etc.
For patients with distant metastases of colorectal cancer, it is necessary to complete the following evaluations before **
Can the patient's general nutritional status, economic status, blood in the stool, intestinal obstruction, etc., tolerate chemotherapy?
Whether various tests have been completed, such as tumor markers of blood, chest and abdomen CT with contrast, whole-body PET-CT (important!) ) and other checks.
No clear colorectal cancer in the pathology? Genetic testing (e.g., mismatch repair genes, KRAS, NRAS, BRAF, etc., important!) ）
Multidisciplinary Discussion (MDT).
Popular classification and ** principles of metastatic colorectal cancer (see figure below, for reference only).
Note: The above **goals or methods** should also pay attention to individual differences and medical information updates in different periods, and need to communicate with the treating physician specifically. Surgical resection is the only decisive method for metastatic colorectal cancer, and it can increase the survival rate of patients by 25% to 50%. However, only 10% to 20% of patients have distant metastases that have a resectable tumor.