About this Research Topic
Currently, Colorectal Cancer (CRC) is the third most common cancer and one of the major causes of cancer-associated mortality worldwide. Interestingly, 20% of patients have metastatic disease at presentation and another 25% with localized disease will later develop metastases. Interestingly, metastatic disease remains the principal cause of mortality in CRC. In fact, the prognosis of metastatic CRC (mCRC) is poor, with a 5-year survival rate of less than 20%.
The management of mCRC has evolved significantly over the years, with the introduction of new therapies as well as an improvement in the understanding of the disease. The current standard of care for mCRC involves a combination of chemotherapy, targeted therapy, and surgery, depending on the individual's disease stage and health status. The goal of treatment is to extend survival, control symptoms, and improve quality of life.
Patient selection is crucial in the planning of the type of treatment for patients with mCRC. For this reason, all metastatic CRC tumors should undergo molecular profiling. Indeed, five percent of mCRCs have microsatellite instability (MSI-H) or mismatch repair deficiency (MMR-D) tumors.
In this context, immunotherapy has recently emerged as a promising new treatment option for mCRC. Immune checkpoint inhibitors such as pembrolizumab and nivolumab have shown efficacy in a subset of patients with high levels of MSI-H and MMR-D.
Chemotherapy is typically the first-line treatment for mCRC and includes a combination fluoropyrimidines, oxaliplatin, and irinotecan. Targeted therapy is often used in conjunction with chemotherapy with a variety of Anti-angiogenic agents, such as bevacizumab, ramucirumab or aflibercept, or epidermal growth factor receptor (EGFR) inhibitors.
Surgery may be useful, often with a palliative role, to remove the primary obstructing tumor or metastases in certain cases, improving patients’ quality of life. In addition, local treatments such as ablation, embolization, and radiation therapy may be added. Lastly, being peritoneal metastases the second most common metastatic site of CRC after the liver, HIPEC with cytoreductive surgery, might be considered in these patients.
The goal of this special issue is to provide a comprehensive overview of the current state of the management of metastatic colorectal cancer (mCRC) while highlighting recent advancements and emerging strategies. This Research Topic aims to bring together cutting-edge research, clinical insights, and innovative approaches to improve patient outcomes and enhance the overall management of mCRC.
1. Reviewing the latest developments in chemotherapy, targeted therapy, and immunotherapy for mCRC.
2. Exploring the role of surgery, including resection of primary tumors and metastases, in the management of mCRC.
3. Investigating novel therapeutic approaches, including combination therapies and personalized medicine, to optimize treatment outcomes.
4. Examining the utility of biomarkers, such as microsatellite instability (MSI-H) and mismatch repair deficiency (dMMR), in predicting response to immunotherapy and guiding treatment decisions.
5. Discussing the impact of multidisciplinary care, including the integration of oncologists, surgeons, radiologists, and pathologists, in delivering comprehensive and individualized treatment for mCRC patients.
6. Addressing challenges and opportunities in managing treatment toxicities, treatment sequencing, and overcoming resistance to current therapies.
7. Highlighting emerging technologies, such as liquid biopsies and molecular profiling, in improving diagnosis, monitoring, and treatment selection for mCRC.
8. Providing insights into supportive care strategies, including symptom management, psychological support, and survivorship care, to enhance the quality of life for patients with mCRC.
9. Identifying gaps in knowledge and outlining future research directions to further advance the field of mCRC management.
Important Note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.
The management of mCRC has evolved significantly over the years, with the introduction of new therapies as well as an improvement in the understanding of the disease. The current standard of care for mCRC involves a combination of chemotherapy, targeted therapy, and surgery, depending on the individual's disease stage and health status. The goal of treatment is to extend survival, control symptoms, and improve quality of life.
Patient selection is crucial in the planning of the type of treatment for patients with mCRC. For this reason, all metastatic CRC tumors should undergo molecular profiling. Indeed, five percent of mCRCs have microsatellite instability (MSI-H) or mismatch repair deficiency (MMR-D) tumors.
In this context, immunotherapy has recently emerged as a promising new treatment option for mCRC. Immune checkpoint inhibitors such as pembrolizumab and nivolumab have shown efficacy in a subset of patients with high levels of MSI-H and MMR-D.
Chemotherapy is typically the first-line treatment for mCRC and includes a combination fluoropyrimidines, oxaliplatin, and irinotecan. Targeted therapy is often used in conjunction with chemotherapy with a variety of Anti-angiogenic agents, such as bevacizumab, ramucirumab or aflibercept, or epidermal growth factor receptor (EGFR) inhibitors.
Surgery may be useful, often with a palliative role, to remove the primary obstructing tumor or metastases in certain cases, improving patients’ quality of life. In addition, local treatments such as ablation, embolization, and radiation therapy may be added. Lastly, being peritoneal metastases the second most common metastatic site of CRC after the liver, HIPEC with cytoreductive surgery, might be considered in these patients.
The goal of this special issue is to provide a comprehensive overview of the current state of the management of metastatic colorectal cancer (mCRC) while highlighting recent advancements and emerging strategies. This Research Topic aims to bring together cutting-edge research, clinical insights, and innovative approaches to improve patient outcomes and enhance the overall management of mCRC.
1. Reviewing the latest developments in chemotherapy, targeted therapy, and immunotherapy for mCRC.
2. Exploring the role of surgery, including resection of primary tumors and metastases, in the management of mCRC.
3. Investigating novel therapeutic approaches, including combination therapies and personalized medicine, to optimize treatment outcomes.
4. Examining the utility of biomarkers, such as microsatellite instability (MSI-H) and mismatch repair deficiency (dMMR), in predicting response to immunotherapy and guiding treatment decisions.
5. Discussing the impact of multidisciplinary care, including the integration of oncologists, surgeons, radiologists, and pathologists, in delivering comprehensive and individualized treatment for mCRC patients.
6. Addressing challenges and opportunities in managing treatment toxicities, treatment sequencing, and overcoming resistance to current therapies.
7. Highlighting emerging technologies, such as liquid biopsies and molecular profiling, in improving diagnosis, monitoring, and treatment selection for mCRC.
8. Providing insights into supportive care strategies, including symptom management, psychological support, and survivorship care, to enhance the quality of life for patients with mCRC.
9. Identifying gaps in knowledge and outlining future research directions to further advance the field of mCRC management.
Important Note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.
Keywords: metastasis, colorectal cancer, surgery, clinical management
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
