This article analyzes the statistical data on colorectal cancer in Russia and in the world, including incidence, mortality and survival. The main pathways of colorectal cancer carcinogenesis, molecular subtypes and their influence on the difference in lesions of the proximal and distal large intestine are presented. The paper provides an overview of the leading chemotherapy agents and targeted therapy in colorectal cancer, as well as the main reasons for the development of therapeutic resistance, including changes in the cellular microenvironment of the tumor.
One of the fundamental events that determine carcinogenesis and its progression is angiogenesis mediated by the activation of the vascular endothelial growth factor (VEGF). The angiogenic cascade provides a comfortable micro-environment for the tumor, the creation of a metastatic niche and subsequent metastatic dissemination of neoplastic cells. The development of a recombinant hyperchimeric monoclonal antibody that selectively binds and inhibits the biological activity of VEGF - Bevacizumab, has led to a change in the therapeutic strategy for patients with cancer and, in particular, for patients with metastatic colorectal cancer (CRC), because it demonstrated an increase in their survival rate.
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