结直肠癌是常见的消化道恶性肿瘤,其发病率和死亡率在全球范围保持上升趋势。目前,治疗晚期或转移性结直肠癌使用的药物主要有5-FU/LV、伊立替康、奥沙利铂、卡培他滨和靶向药物,包括西妥昔单抗和贝伐珠单抗。然而靶向治疗在不同患者中的获益率却存在差异,目前推荐西妥昔单抗用于K-ras基因野生型患者,治疗前检测肿瘤K-ras基因状态可作为疗效预测因子。除此以外,EGFR活化通路中的其他一些预测因子如BRAF、PIK3CA、PTEN等对靶向治疗的疗效亦有一定的预测作用。作者在系统回顾已有研究结果的基础上,对PTEN等预测因子在转移性结直肠癌患者中使用西妥昔单抗等靶向治疗的预测作用进行了总结,并归纳了近年来结直肠癌个体化治疗的发展。

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