Application of neoadjuvant chemotherapy in the treatment of colorectal cancer

doi:10.3877/cma.j.issn.2095-2015.2023.01.008

Abstract

Abstract:

Colorectal cancer(CRC)is the third most common malignant tumor in the world and the second most common cause of cancer death.Surgery is the main treatment.Because the symptoms of colorectal cancer are not obvious in the early stage, most patients have missed the opportunity of surgery.For patients with resectable tumors, neoadjuvant chemotherapy is used to improve local control rate and overall survival rate.For patients with unresectable tumors, transformation therapy is used to transform them into resectable state, followed by surgical resection.Neoadjuvant chemotherapy is suitable for patients with tumor in middle stage or difficult to be resected as well as difficult to be removed completely.It can reduce the tumor stage and make the tumor shrink so as to facilitate subsequent surgery and radiotherapy.Domestic and foreign studies have found that preoperative neoadjuvant chemotherapy contributes to the improvement of surgical resection rate and prolongs postoperative survival of patients.This article reviews the application principles, efficacy evaluation, clinical benefits and risks of neoadjuvant chemotherapy in the treatment of colorectal cancer.

Key words: Colorectal cancer, Neoadjuvant chemotherapy, Hepatic metastases, Multidisciplinary comprehensive treatment

Ying Du, Lili Cao. Application of neoadjuvant chemotherapy in the treatment of colorectal cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(01): 39-45.

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References 66

1	唐军，杨静芳．新辅助化疗治疗直肠癌的研究现状[J]．基层医学论坛，2019，23(1)：124-125.
2	Kollings FT.Diagnostics and Epidemiology of Colorectal Cancer [J]．Visceral Medicine，2016，32(3)：158-164.
3	NCCN clinical practice guidelines in oncology：Colon Cancer(2020 version 1)[EB/OL]．(2019-12-19)． URL
4	Siegel RL，Miller KD，Goding Sauer A．Colorectal cancer statistics，2020 [J]．CA Cancer J Clin，2020，70(3)：145-164.
5	樊嘉，顾晋，秦新裕，等．中国结直肠癌肝转移诊断和综合治疗指南(2020)[J]．中国临床医学，2021，28(1)：129-144.
6	Modest DP，Pant S，Sartore-BianchiI A．Treatment sequencing in metastatic colorectal cancer [J]．Eur J Cancer，2019，109：70-83.
7	Zhu X，Tian X，Ji L，et al.A tumor microenvironment-specific gene expression signature predicts chemotherapy resistance in colorectal cancer patients [J]．NPJ Precision Oncology，2021，5(1)：7.
8	Cercek A，Dos Santos Fernandes G，Roxburgh CS，et al.Mismatch Repair-Deficient Rectal Cancer and Resistance to Neoadjuvant Chemotherapy [J]．Clin Cancer Res，2020，26(13)：3271-3279.
9	Johnson RM，Qu X，Lin CF，et al.ARID1A mutations confer intrinsic and acquired resistance to cetuximab treatment in colorectal cancer [J]．Nature Communications，2022，13(1)：5478.
10	Temraz S，Nassar F，Nasr R，et al.Gut Microbiome：A Promising Biomarker for Immunotherapy in Colorectal Cancer [J]．Int J Mol Sci，2019，20(17)：4155.
11	Yu T，Guo F，Yu Y，et al.Fusobacterium nucleatum Promotes Chemoresistance to Colorectal Cancer by Modulating Autophagy [J]．Cell，2017，170(3)：548-563.e16.
12	Chang CW，Lee HC，Li LH，et al.Fecal Microbiota Transplantation Prevents Intestinal Injury，Upregulation of Toll-Like Receptors，and 5-Fluorouracil/Oxaliplatin-Induced Toxicity in Colorectal Cancer [J]．Int J Mol Sci，2020，21(2)：386.
13	Liu T，Zhang X，Du L，et al.Exosome-transmitted miR-128-3p increase chemosensitivity of oxaliplatin-resistant colorectal cancer [J]．Molecular Cancer，2019，18(1)：43.
14	Wang K，Liu M，Wang HW，et al.Mutated DNA Damage Repair Pathways Are Prognostic and Chemosensitivity Markers for Resected Colorectal Cancer Liver Metastases [J]．Front Oncol，2021，11：643375.
15	Liu G，Lai D，Jiang Y，et al.Demethylzeylasteral Exerts Antitumor Effects via Disruptive Autophagic Flux and Apoptotic Cell Death in Human Colorectal Cancer Cells and Increases Cell Chemosensitivity to 5-Fluorouracil [J]．Anticancer Agents Med Chem，2022，22(5)：851-863.
16	Luo W，Liu Q，Chen X，et al.FXYD6 Regulates Chemosensitivity by Mediating the Expression of Na+/K+-ATPaseα1 and Affecting Cell Autophagy and Apoptosis in Colorectal Cancer [J]．BioMed Research International，2021，2021：9986376.
17	Guo J，Zheng J，Mu M，et al.GW4064 enhances the chemosensitivity of colorectal cancer to oxaliplatin by inducing pyroptosis [J]．Biochemical and Biophysical Research Communications，2021，548：60-66.
18	Zhang Y，Kang M，Zhang B，et al.m(6)A modification-mediated CBX8 induction regulates stemness and chemosensitivity of colon cancer via upregulation of LGR5 [J]．Molecular Cancer，2019，18(1)：185.
19	Hervieu C，Verdier M，Barthout E，et al.A Label-Free Cell Sorting Approach to Highlight the Impact of Intratumoral Cellular Heterogeneity and Cancer Stem Cells on Response to Therapies [J]．Cells，2022，11(15)：2264.
20	Soleimani A，Zahiri E，Ehtiati S，et al.Therapeutic potency of heat-shock protein-70 in the pathogenesis of colorectal cancer：current status and perspectives [J]．Biochem Cell Biol，2019，97(2)：85-90.
21	Xing Y，Jing H，Zhang Y，et al.MicroRNA-141-3p affected proliferation，chemosensitivity，migration and invasion of colorectal cancer cells by targeting EGFR [J]．Int J Biochem Cell Biol，2020，118：105643.
22	Sun J，Yao N，Lu P，et al.Effects of mFOLFOX6 regimen combined with carrelizumab on immune function and prognosis in patients with microsatellite instability colorectal cancer [J]．Cellular Molecular Biology，2022，67(5)：356-362.
23	Cao X，Luo J，Zhao B，et al.Pathological complete response after neoadjuvant immunotherapy combined with chemotherapy in pediatric rectal carcinoma：A case report [J]．Front Immunol，2022，13：1036181.
24	Lin Z，Cai M，Zhang P，et al.Phase II，single-arm trial of preoperative short-course radiotherapy followed by chemotherapy and camrelizumab in locally advanced rectal cancer [J]．J Immunother Cancer，2021，9(11)：e003554.
25	Zhou H，Wang Y，Lin Y，et al.Preliminary Efficacy and Safety of Camrelizumab in Combination With XELOX Plus Bevacizumab or Regorafenib in Patients With Metastatic Colorectal Cancer：A Retrospective Study [J]．Front Oncol，2021，11：774445.
26	Li YJ，Zhang L，Dong QS，et al.Short-term outcome of programmed cell death protein1(PD-1)antibody combined with total neoadjuvant chemoradiotherapy in the treatment of locally advanced middle-low rectal cancer with high risk factors[J]．Chin J Gastrointest Surg，2021，24(11)：998-1007.
27	DIAGNOSIS，TREATMENT GUIDELINES FOR COLORECTAL CANCER WORKING GROUP C．Chinese Society of Clinical Oncology(CSCO)diagnosis and treatment guidelines for colorectal cancer 2018(English version)[J]．Chin J Cancer Res，2019，31(1)：117-134.
28	赵洪川，高春．结直肠癌新辅助治疗疗效的评价标准[J]．国际消化病杂，2011，31(5)：253-255.
29	Rubbia-Brandt L，Giostra E，Brezault C，et al.Importance of histological tumor response assessment in predicting the outcome in patients with colorectal liver metastases treated with neo-adjuvant chemotherapy followed by liver surgery [J]．Ann Oncol，2007，18(2)：299-304.
30	Dbouk HA，Tawil A，Nasr F，et al.Significance of CEA and VEGF as Diagnostic Markers of Colorectal Cancer in Lebanese Patients [J]．Open Clin Cancer J，2007，1：1-5.
31	Yakabe T，Nakafusa Y，Sumi K，et al.Clinical significance of CEA and CA19-9 in postoperative follow-up of colorectal cancer [J]．Ann Surg Oncol，2010，17(9)：2349-2356.
32	赵凌昆，王新，赵云波．FAP-α和SDF-1预测新辅助化疗结直肠癌病人预后的研究[J]．牡丹江医学院学报，2020，41(2)：38-41，64.
33	Nasseri Y，Langenfeld SJ.Imaging for Colorectal Cancer [J]．Surg Clin N Am，2017，97(3)：503-513.
34	韩超，陈新晖．磁共振弥散加权成像ADC值对结直肠癌放化疗疗效的评估价值[J]．中国CT和MRI杂志，2021，19(8)：144-147.
35	Lech G，Sotwiński R，Sodkowski M，et al.Colorectal cancer tumour markers and biomarkers：Recent therapeutic advances [J]．World J Gastroenterol，2016，22(5)：1745-1755.
36	Ribic CM，Sargent DJ，Moore MJ，et al.Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer [J]．N Engl J Med，2003，349(3)：247-257.
37	Sargent DJ，Marsoni S，Monges G，et al.Defective mismatch repair as a predictive marker for lack of efficacy of fluorouracil-based adjuvant therapy in colon cancer [J]．J Clin Oncol，2010，28(20)：3219-3226.
38	Tie J，Cohen JD，Wang Y，et al.Serial circulating tumour DNA analysis during multimodality treatment of locally advanced rectal cancer：a prospective biomarker study [J]．Gut，2019，68(4)：663-671.
39	Bhangu JS，Beer A，Mittlböck M，et al.Circulating Free Methylated Tumor DNA Markers for Sensitive Assessment of Tumor Burden and Early Response Monitoring in Patients Receiving Systemic Chemotherapy for Colorectal Cancer Liver Metastasis [J]．Ann Surg，2018，268(5)：894-902.
40	Sposato LA，Lam Y，Karapetis C，et al.Observation of " complete clinical response" in rectal cancer after neoadjuvant chemoradiation：The Flinders experience [J]．Asia Pac J Clin Oncol，2018，14(6)：439-445.
41	董亚军．外周血中性粒细胞、淋巴细胞及其比值在进展期直肠癌新辅助化疗中的疗效评估及临床意义[D]．南充：川北医学院，2019.
42	Ciliberto D，Prati U，Roveda L，et al.Role of systemic chemotherapy in the management of resected or resectable colorectal liver metastases：a systematic review and meta-analysis of randomized controlled trials [J]．Oncol Rep，2012，27(6)：1849-1856.
43	Wang ZM，Chen YY，Chen FF，et al.Peri-operative chemotherapy for patients with resectable colorectal hepatic metastasis：A meta-analysis [J]．Eur J Surg Oncol，2015，41(9)：1197-1203.
44	Wang LJ，Wang HW，Jin KM，et al.Comparative study on prognosis of neoadjuvant chemotherapy followed by hepatic surgery versus upfront surgery in patients with synchronous colorectal liver metastasis[J]．Chin J Gastrointest Surg，2021，24(3)：248-255.
45	张卫刚．新辅助同步放化疗联合诱导化疗、巩固化疗治疗局部进展期直肠癌的临床研究[D]．上海：第二军医大学，2017.
46	Khoo E，O′Neill S，Brown E，et al.Systematic review of systemic adjuvant，neoadjuvant and perioperative chemotherapy for resectable colorectal-liver metastases [J]．HPB(Oxford)，2016，18(6)：485-493.
47	Brandi G，De Lorenzo S，Nannini M，et al.Adjuvant chemotherapy for resected colorectal cancer metastases：Literature review and meta-analysis [J]．World J Gastroenterol，2016，22(2)：519-533.
48	Araujo RL，Gönen M，Herman P．Chemotherapy for patients with colorectal liver metastases who underwent curative resection improves long-term outcomes：systematic review and meta-analysis [J]．Ann Surg Oncol，2015，22(9)：3070-3078.
49	Araujo R，Gonen M，Allen P，et al.Comparison between perioperative and postoperative chemotherapy after potentially curative hepatic resection for metastatic colorectal cancer [J]．Ann Surg Oncol，2013，20(13)：4312-4321.
50	付尚志，张佳节，李万平．直肠癌术前新辅助放化疗研究进展[J]．临床军医杂志，2015，43(4)：409-412.
51	Bhudia J，Glynne-Jones R，Smith T，et al.Neoadjuvant Chemotherapy without Radiation in Colorectal Cancer [J]．Clin Colon Rectal Surg，2020，33(5)：287-297.
52	Kemeny NE，Niedzwiecki D，Hollis DR，et al.Hepatic arterial infusion versus systemic therapy for hepatic metastases from colorectal cancer：a randomized trial of efficacy，quality of life，and molecular markers(CALGB 9481)[J]．J Clin Oncol，2006，24(9)：1395-1403.
53	Benoist S，Brouquent A，Penna C，et al.Complete response of colorectal liver metastases after chemotherapy：does it mean cure? [J]．J Clin Oncol，2006，24(24)：3939-3945.
54	Leonard GD，Brenner B，Kemeny NE.Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma [J]．J Clin Oncol，2005，23(9)：2038-2048.
55	Van Vledder MG，De Jong MC，Pawlik TM，et al.Disappearing colorectal liver metastases after chemotherapy：should we be concerned? [J]．J Gastrointest Surg，2010，14(11)：1691-1700.
56	Bischof DA，Clary BM，Maithel SK，et al.Surgical management of disappearing colorectal liver metastases [J]．Br J Surg，2013，100(11)：1414-1420.
57	Bilchik AJ，Poston G，Curley SA，et al.Neoadjuvant chemotherapy for metastatic colon cancer：a cautionary note [J]．J Clin Oncol，2005，23(36)：9073-9078.
58	Hubert C，Lucidi V，Weerts J，et al.Impact of biological agents on the prevalence of chemotherapy associated liver injury(CALI)：Multicentric study of patients operated for colorectal liver metastases [J]．Eur J Surg Oncol，2018，44(10)：1532-1538.
59	ViganòL，Capussotti L，De Rosa G，et al.Liver resection for colorectal metastases after chemotherapy：impact of chemotherapy-related liver injuries，pathological tumor response，and micrometastases on long-term survival [J]．Ann Surg，2013，258(5)：731-740.
60	Choti MA.Chemotherapy-associated hepatotoxicity：do we need to be concerned? [J]．Ann Surg Oncol，2009，16(9)：2391-2394.
61	Kishi Y，Zorzi D，Contreras CM，et al.Extended preoperative chemotherapy does not improve pathologic response and increases postoperative liver insufficiency after hepatic resection for colorectal liver metastases [J]．Ann Surg Oncol，2010，17(11)：2870-2876.
62	Rubbia-Brandt L，Audard V，Sartoretti P，et al.Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer [J]．Ann Oncol，2004，15(3)：460-466.
63	Vauthey JN，Pawlik TM，Ribero D，et al.Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases [J]．J Clin Oncol，2006，24(13)：2065-2072.
64	Adam R，Vinet E．Regional treatment of metastasis：surgery of colorectal liver metastases [J]．Ann Oncol，2004，15(4)：103-106.
65	葛大壮，赵建军，黄振，等．MDT指导下多程治疗直肠癌肝转移临床治愈一例[J/OL]．肝癌电子杂志，2019，6(3)：24-27.
66	Zhao J，Van Mierlo KMC，Gómez-Ramírez J，et al.Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases [J]．Br J Surg，2017，104(8)：990-1002.

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