Abstract
(1) Background: colorectal cancer (CRC) is one of the deadliest causes of death by cancer worldwide. Its first main metastatic diffusion spreads to the liver. Different mechanisms such as the epithelial–mesenchymal transition and angiogenesis are the characteristics of this invasion. At this stage, different options are possible and still in debate, especially regarding the use of targeted therapeutics and biotherapies. (2) Methods: A review of the literature has been done focusing on the clinical management of liver metastasis of colorectal cancer and the contribution of biotherapies in this field. (3) Results: In a clinical setting, surgeons and oncologists consider liver metastasis in CRC into two groups to launch adapted therapeutics: resectable and non-resectable. Around these two entities, the combination of targeted therapies and biotherapies are of high interest and are currently tested to know in which molecular and clinical conditions they have to be applied to impact positively both on survival and quality of life of patients.
Highlights
The management of colorectal metastases of the liver varies on colorectal cancer (CRC) disease burden, patient suitability, clinical correlation and appropriateness of treatments decided by cancer multidisciplinary team (MDT)
Intrinsic or acquired resistance may exist and identifying these potential resistances to targeted therapies are of high importance: (1) Predicting resistance to the Epidermal Growth Factor Receptor (EGFR)-targeted monoclonal antibodies: different studies have demonstrated that combined detection of NRAS, PTEN and PI3K genes status in wild-type KRAS CRC patients, can identify patients who are more prone to not respond to anti-EGFR therapies [82] and (2) identifying intrinsic and acquired resistance to drugs targeting the EGFR-RAS-RAF pathway in CRC, in addition to identifying potential biomarkers for resistance of tumours that are dependent on Mitogenvated protein kinase/extracellular-signal-regulated kinase (ERK) kinase (MEK)
Despite increasing clinical data regarding the therapeutic role of immunotherapy among DNA mismatch repair (dMMR) or MSI-H mCRC, evidence for most patients harbouring pMMR or MSS tumours still do not benefit from immunotherapeutic agents [124]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The liver is of anatomical and physiological importance in regard to the natural course of CRC. The management of colorectal metastases of the liver varies on CRC disease burden, patient suitability, clinical correlation and appropriateness of treatments decided by cancer multidisciplinary team (MDT). The development of novel and effective biotherapies in conjunction with chemotherapies for colorectal metastases have changed the natural course of CRC by enhancing the host’s own immunological anti-tumour responses against CRC and already shown to have a good potential and improve the prognosis of the disease. Treatment strategies utilizing and evaluating the benefit of the use of biotherapies in CRLM of the liver remain unclear. Biomedicines 2021, 9, 894 the current strategies and available biotherapies in use or in trials for the management and treatment of CRC metastases of the liver
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