Published online Oct 21, 2018. doi: 10.3748/wjg.v24.i39.4428
Peer-review started: July 10, 2018
First decision: July 18, 2018
Revised: August 24, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 21, 2018
Colorectal cancer (CRC) is the third most common cancer of mortality in the world. Chemotherapy based treatment leads to innumerable side effects as it delivers the anticancer drug to both normal cells besides cancer cells. Sonic Hedgehog (SHH), Wnt wingless-type mouse mammary tumor virus/β-catenin, transforming growth factor-β/SMAD, epidermal growth factor receptor and Notch are the main signaling pathways involved in the progression of CRC. Targeted therapies necessitate information regarding the particular aberrant pathways. Advancements in gene therapies have resulted in the recognition of novel therapeutic targets related with these signal-transduction cascades. CRC is a step-wise process where mutations occur over the time and activation of oncogenes and deactivation of tissue suppressor genes takes place. Genetic changes which are responsible for the induction of carcinogenesis include loss of heterozygosity in tumor suppressor genes such as adenomatous polyposis coli, mutation or deletion of genes like p53 and K-ras. Therefore, many gene-therapy approaches like gene correction, virus-directed enzyme-prodrug therapy, immunogenetic manipulation and virotherapy are currently being explored. Development of novel strategies for the safe and effective delivery of drugs to the cancerous site is the need of the hour. This editorial accentuates different novel strategies with emphasis on gene therapy and immunotherapy for the management of CRC.
Core tip: In spite of the advancements in the diagnosis and the treatment approaches for colorectal cancer (CRC), its survival rate is quite low. Therefore, there arises an urge to develop novel targeting strategies for its effective treatment. A meticulous apprehension of the signaling cascade is necessitated for better outcomes. In a nutshell, this editorial highlights various novel targeting approaches like gene therapy and immunotherapy which could usher better targeting of CRC.