中国实用外科杂志2024，Vol.44Issue(7)：730-732,736,4.DOI:10.19538/j.cjps.issn1005-2208.2024.07.02
2024年V2版《美国国家综合癌症网络结肠癌临床实践指南》更新解读
Interpretation of the updated NCCN clinical practice guidelines in oncology:colon cancer(version 2.2024)
摘要
Abstract
The 2024 V2 guideline update encompasses multiple fields of diagnosis and treatment,with a particular focus on advancements in molecular diagnostic techniques,the latest developments in immunotherapy,and adjustments to comprehensive treatment regimens.In molecular testing,the guideline recommends a more comprehensive genetic analysis for patients with suspected or confirmed metastatic adenocarcinoma,including rare gene mutations/fusions such as POLE/POLDI,RET,and NTRK,and keep monitoring gene mutations like HER2,RAS,and BRAF.Regarding the application of circulating tumor DNA(ctDNA),the guideline adopts a conservative stance and suggests its usage in clinical trials,with special caution in stage Ⅱ or Ⅲ patients and those undergoing adjuvant therapy.In treatment updates,patients with POLE/POLD1 mutations and dMMR/MSI-H are recommended to receive immunotherapy,particularly in cases of unresectable metastases.The restriction of anti-EGFR therapy on left-sided colon tumors has been deleted,broadening its application to all eligible KRAS/NRAS/BRAF wild-type patients.Meanwhile,the use of trastuzumab has also been expanded for all HER2-amplified colon cancer patients.Additionally,the guideline has restructured and updated recommendations for adjuvant chemotherapy in dMMR/MSI-H patients,clarifying the potential limitations of adjuvant chemotherapy in improving survival rates.关键词
美国国家综合癌症网络/结肠癌/指南/解读Key words
National Comprehensive Cancer Network/colon cancer/guideline/interpretation分类
医药卫生引用本文复制引用
李心翔,张瑞嘉..2024年V2版《美国国家综合癌症网络结肠癌临床实践指南》更新解读[J].中国实用外科杂志,2024,44(7):730-732,736,4.基金项目
国家自然科学基金项目(No.81972260,No.82003060) （No.81972260,No.82003060）
