Preface

Since the importance of the various intracellular environmental changes experienced during the carcinogenesis of colorectal cancer cannot be overlooked, a variety of strategies should be considered. This book describes and examines these strategies.

Chapter 1 provides an introduction and overview of the topics covered herein. Chapter 2 focuses on prevention of colorectal cancer and provides information regarding the role of diet, alcoholic beverages, vitamins, fatness, physical activity, and dietary supplements. Chapter 3 explains the pathogenesis of colorectal cancer as well as examines development of new drugs targeting the disease. Chapter 4 introduces an unconventional method of colorectal cancer therapy, photodynamic therapy, and examines its efficacy. Chapter 5 describes the relationship between immune scores and microbiomes in colorectal cancer prognosis by using a scoring system that analyzes the consequences of the immune balance. The final chapter compares currently available systemic treatment options, efficacy, and safety profiles for understanding patients with advanced colorectal cancer.

 The existing colorectal cancer therapies, including surgery, chemotherapy, and radiotherapy, are indispensable options, however, there is plenty of room for improvement in efficacy and toxicity. And the process for these improvements is always in progress. Cancer treatment is expected to be sufficiently improved by adopting a multidisciplinary approach within an integrated framework including initiation, promotion, and progression, under the context of emphasizing the use of standard therapies according to current criteria. In this regard, *Multidisciplinary Approach for Colorectal Cancer* provides useful information for healthcare practitioners and other interested readers.

**II**

**Section 6**

*by Aneta L. Zygulska*

Understanding Therapeutics for Advanced Colorectal Cancer **77**

**Chapter 6 79** Further Therapeutic Options in Heavily Pretreated Colorectal Cancer Patients

## **Keun-Yeong Jeong**

Metimedi Pharmaceuticals Co., LTD., Senior Vice President, Head of Research center, Geobukgol-ro, Seoul, Republic of Korea

**1**

Section 1

Introduction

Section 1 Introduction

**3**

**Chapter 1**

*Keun-Yeong Jeong*

**1. General facts on colorectal cancer**

better potential therapies is still ongoing.

Introductory Chapter:

Multidisciplinary Colorectal

Cancer - First Steps to Encompass

Various Strategies for Preventing

Over the past decades, significant progress has been made in clinical and preclinical sciences. It has been lucky to see the integration of multiple discovery disciplines in science and medicine to push the limits of diagnosis and treatment of disorders that can affect many diseases. However, cancer is an exceptional disease that is relatively intractable and despite the multiple discovery disciplines scholarly. Colorectal cancer (CRC) is the third most common cause of cancer-associated mortality worldwide. According to the data from the National Center for Health Statistics, about 135,000 people are estimated to undergo chemotherapy with CRC in the USA each year, and approximately 50,000 people succumb to the disease annually [1]. Additionally, estimation of the Global Cancer Control project indicated that nearly 2 million people worldwide were diagnosed every year [2]. Wellknown option targeting CRC treatment is currently suggested surgical resection preferentially, and if the tumor progression is in an advanced stage, it does require combination with chemotherapy and/or radiation therapy. There is no doubt that surgery, chemotherapy, and radiation therapy are the best choices for treating CRC, even therapeutic efficiency is improving. However, it is still insufficient to reach a convincing level except for the case of early detection; therefore the craving for

**2. Importance of a multidisciplinary approach targeting CRC**

To date, the multidisciplinary approach, including initiation, promotion, and progression, which is the process leading to the final diagnosis of CRC is growing interest [3, 4]. These three series of processes belong to carcinogenesis, and it is defined as the process by which environmental and genetic change from normal cells to the final diagnosis of cancer. Initiation includes genetic changes that occur spontaneously or are induced by exposure to carcinogens. Abnormal genetic changes can lead to dysregulation of signaling pathways associated with cell growth, survival, and differentiation [3, 4]. The promotion stage is taken into account in a relatively long and reversible process in which actively growing

and Treating Colorectal Cancer
