2017. V1版《NCCN 结直肠癌诊治指南》更新解读

摘要

本文对2017. V1版《NCCN 结直肠癌诊治指南》进行了解读。与2016. V2版《NCCN 结直肠癌诊治指南》相比，新版指南做出了一些能改变临床实践的更新，其中最为重要的几点包括：（1）建议服用小剂量阿司匹林作为结直肠癌（CRC）术后的二级化学预防；（2）RAS 野生型转移性 CRC（mCRC）的一线靶向治疗中，表皮细胞生长因子受体（EGFR）单抗仅限于左半结肠癌患者；（3）可切除肝/肺转移瘤的新辅助化疗中不推荐使用靶向药物；（4）推荐程序性死亡受体（PD -1）单抗用于 MMR 突变（dMMR）/ MSI - H 的 mCRC 之末线治疗。%This paper interpreted NCCN Guidelines for Colon Cancer and Rectal Cancer(Version 1. 2017). Compared with Version 2. 2016,the latest guideline made some significant updates,and the most important points included: (1) considering low - dose aspirin as the secondary chemoprevention for colorectal cancer(CRC)survivors;(2)in the first - line targeted therapy of RAS wide - type CRC(mCRC),EGFR inhibitors(cetuximab or panitumumab)should only be offered to patients whose primary tumors originated on the left side of the colon and rectum; ( 3 )the panel recommends against panitumumab and cetuximab in the neoadjuvant chemotherapy of resectable metastatic liver or lung neoplasms;(4)the panel recommends programmed death receptor - 1(PD - 1)inhibitors as treatment options in mCRC patients with metastatic deficient MMR(dMMR)or MSI - H in second - or third - line therapy.