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Vers un traitement personnalisé du cancer colorectal: facteurs pronostiques et prédictifs

Toward a personalized treatment of colorectal cancer: prognostic and predictive factors

  • Oncologie
  • Published:
Oncologie

Abstract

Colorectal cancer (CRC) remains a major public health problem despite the advent of several conventional chemotherapies and targeted therapies. The identification of prognostic factors, and also factors that can predict response to different treatments and their toxicity, has become amajor issue in order to optimize and personalize treatment of CRC patients. Although few molecular factors are validated in the field of CRC prognosis where the TNM classification is the main parameter used in clinical practice, the fact is not true for molecular predictive factors. Several of them are now validated for predicting response to certain treatments (KRAS mutations and anti-EGFR antibodies) and their toxicity (dihydropyrimidine déshydrogenase [DPD] for 5-fluorouracil [5-FU], UDP-glucuronosyltransferase 1A1 [UGT 1A1] polymorphism for irinotecan) and open up the way of personalized treatment of CRC.

Résumé

Le cancer colorectal (CCR) reste un problème majeur de santé publique malgré l’avènement de plusieurs chimiothérapies et thérapies ciblées. L’identification de facteurs pronostiques, mais aussi de facteurs prédictifs de la réponse à ces différents traitements et de leur toxicité est devenue un enjeu majeur afin d’optimiser et de personnaliser le traitement du CCR. Si peu de facteurs moléculaires sont validés dans le domaine du pronostic des CCR où la classification TNM reste le principal paramètre utilisé en pratique clinique, il n’en est pas de même des facteurs moléculaires prédictifs. Plusieurs d’entre eux sont désormais validés pour la prédiction de la réponse à certains traitements (mutations de KRAS et anticorps anti-EGFR) ou à leur toxicité (dihydropyrimidine déshydrogénase [DPD] et 5-fluorouracile [5-FU], polymorphismes de l’UDP-glucuronosyltransférase 1A1 [UGT 1A1] et irinotécan) et ouvrent la voie d’un traitement personnalisé du CCR.

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Authors and Affiliations

  1. Service d’hépatogastroentérologie et oncologie digestive, hôpital Ambroise-Paré, AP-HP, F-92104, Boulogne-Billancourt, France

    A. Lièvre

  2. Université Versailles Saint-Quentin-en-Yvelines, 23, rue du Refuge, F-78000, Versailles, France

    A. Lièvre

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Lièvre, A. Vers un traitement personnalisé du cancer colorectal: facteurs pronostiques et prédictifs. Oncologie 12, 584–592 (2010). https://doi.org/10.1007/s10269-010-1952-1

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  • DOI: https://doi.org/10.1007/s10269-010-1952-1

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