Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2023; 15(4): 495-519
Published online Apr 27, 2023. doi: 10.4240/wjgs.v15.i4.495
Current and emerging therapeutic approaches for colorectal cancer: A comprehensive review
Anil Kumar, Vipasha Gautam, Arushi Sandhu, Kajal Rawat, Antika Sharma, Lekha Saha
Anil Kumar, Vipasha Gautam, Arushi Sandhu, Kajal Rawat, Antika Sharma, Lekha Saha, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Kumar A performed the conceptualization, wrote the original draft preparation, and contributed to software, visualization and investigation, and reviewing and editing; Gautam V, Sandhu A, and Sharma A wrote the original draft preparation; Rawat K wrote the original draft preparation and performed the proofreading; Saha L contributed to the conceptualization, supervision, and reviewing and editing.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lekha Saha, MBBS, MD, MNAMS, Full Professor, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Research Block B, Chandigarh 160012, India. lekhasaha@rediffmail.com
Received: October 21, 2022
Peer-review started: October 21, 2022
First decision: January 3, 2023
Revised: January 11, 2023
Accepted: March 3, 2023
Article in press: March 3, 2023
Published online: April 27, 2023
Abstract

Colorectal cancer (CRC) affects 1 in 23 males and 1 in 25 females, making it the third most common cancer. With roughly 608000 deaths worldwide, CRC accounts for 8% of all cancer-related deaths, making it the second most common cause of death due to cancer. Standard and conventional CRC treatments include surgical expurgation for resectable CRC and radiotherapy, chemotherapy, immunotherapy, and their combinational regimen for non-resectable CRC. Despite these tactics, nearly half of patients develop incurable recurring CRC. Cancer cells resist the effects of chemotherapeutic drugs in a variety of ways, including drug inactivation, drug influx and efflux modifications, and ATP-binding cassette transporter overexpression. These constraints necessitate the development of new target-specific therapeutic strategies. Emerging therapeutic approaches, such as targeted immune boosting therapies, non-coding RNA-based therapies, probiotics, natural products, oncolytic viral therapies, and biomarker-driven therapies, have shown promising results in preclinical and clinical studies. We tethered the entire evolutionary trends in the development of CRC treatments in this review and discussed the potential of new therapies and how they might be used in conjunction with conventional treatments as well as their advantages and drawbacks as future medicines.

Keywords: Colorectal cancer, Chemotherapy, Immunotherapy, RNA interference, Probiotics, Oncolytic viral therapy

Core Tip: This review highlights some of the latest colorectal cancer treatment approaches that have the potential to soon translate into standard care. A vast literature of patient data has revealed that conventional therapies are non-specific and have numerous secondary complications. Additionally, patients develop resistance to conventional chemotherapies. There is a need to develop new target-specific arrows in the cancer-fighting quiver.