title: Search for novel target molecules for the effective treatment or prevention of colorectal cancer.
abstract: The 5-year survival rate is more than 70% for patients without distant metastasis, while it is 10-20% for those with distant metastatic disease, suggesting the essential development of effective perioperative therapy. In a combination of cetuximab and FOLFIRI, the rate of conversion to resectable liver metastases is about 30%, and oncogenic activation of intracellular signaling pathway downstream of epidermal growth factor receptor, like KRAS mutations, is an important mechanism of resistance to anti-epidermal growth factor receptor therapy. Other molecules in oncogenic signal transduction and microRNA are attracting attention as candidates for new molecular targets. A cancer stem cell theory has been advocated even in gastrointestinal tract cancer and thought to be involved in multidrug resistance via ATP-binding cassette transport and active DNA repair. Despite newly-devised therapeutic ways, curative treatment of advanced colorectal cancer (CRC) leading to development of prevention is still difficult. Currently, the most effective preventive strategy is endoscopic polypectomy. A most recent report showed removal of adenoma was conducive to a 77% lower risk for CRC after 10 years. However, another means of prevention needs to be developed for familial adenomatous polyposis and hereditary non-polyposis CRC. Adding to the micronutrients, several key molecules have been investigated as target candidates for chemoprevention. A deeper understanding of the biology of CRC has been expanded, which is resulting in the development of novel therapies.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan. mt@gh.med.osaka-u.ac.jp
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsujii
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018890:Chemoprevention; D003111:Colonic Polyps / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000517:prevention & control*; D003131:Combined Modality Therapy; D006801:Humans
chemical_list: D000970:Antineoplastic Agents