The role of preoperative chemotherapy for colorectal cancer metastases in the liver with the lack of RAS mutations

Abstract

Colorectal cancer (CRC) is one of the most common malignancies, occupying the third place in the world among malignant tumors morbidity rate and the 4th place on the causes of death. Every year in the world there are diagnosed more than 1.3 millions of new cases of the disease. The mortality rate continues to be one of the most common causes in the structure of cancer incidence. In Russia, each year there are diagnosed more than 60 thousands of new cases of colorectal cancer. For the last time the incidence increased by 11%, out of them more than 17 thousands patients show newly diagnosed distant metastases. In the absolute majority of cases metastases in the liver are firstly detected in 2-3 years. Liver is the organ- the most commonly affected by metastases. Methods of medicinal treatment of CRC metastases are of great importance and allowed to greatly improve the life expectancy of patients. Median overall survival (OS) is 35-40 months. The one of the last achievement of the modern drug therapy of metastatic CRC was the appearance of the preparation Cetuximab. Blocking of the KRAS gene is a key compartment of the signaling pathways that transmit extracellular growth signals from the surface of the cell to the nucleus. Further signals are transmitted via the cascade into the cellular nucleus, regulating cell growth, proliferation, angiogenesis, invasion and metastasis. Results of the research of PRIME, PEAK and FIRE-3 confirm the advantage of supplement ofpanitumumab or cetuximab to chemotherapy regimens FOLFOX or FOLFIRI in patients with wild-type Ras.