Abstract
Liver metastasis is the primary contributor to the death of patients with colorectal cancer. Despite the overall success of current treatments including targeted therapy, chemotherapy, and immunotherapy combinations in colorectal cancer patients, the prognosis of patients with liver metastasis remains poor. Recent studies have highlighted the importance of the tumour microenvironment and the crosstalk within that determines the fate of circulating tumour cells in distant organs. Understanding the interactions between liver resident cells and tumour cells colonising the liver opens new therapeutic windows for the successful treatment of metastatic colorectal cancer. Here we discuss critical cellular interactions within the tumour microenvironment in primary tumours and in liver metastases that highlight potential therapeutic targets. We also discuss recent therapeutic advances for the treatment of metastatic colorectal cancer.
Highlights
Colorectal cancer is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women
FOXP3+ immune cells) in metastatic colorectal cancer lesions at the invasive margin of liver metastases correlated positively to chemotherapy responses with 100% specificity, with high immune infiltrates correlating with longer progression-free survival in patients who received chemotherapy [27]
interleukin 6 (IL-6) is highly expressed in colon cancer cells and promotes progression into liver metastasis through IL-6/Janus kinase (JAK)/signal transducer and activator of transcription (STAT)
Summary
Colorectal cancer is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women. While incidence rates have dropped by ~3.6% each year from 2007 to 2016 in older adults greater than 55 years in age, incidence rates have risen by 2% each year in younger adults (20–49 years), a trend observed worldwide [4,5,7] This alarming trend in the increase in colon cancer in the younger demographic is suggestive of lifestyle and environmental factors as contributors to early onset. (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), will influence rates of detection rates, accessibility to treatment, as well as changes in approaches employed in the management of colorectal cancer during the period of 2020 and 2021 [8,9,10] These changing circumstances worldwide are likely, in future, to have significant influence on colon cancer mortality and incidence rates in a manner previously not observed
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