结直肠癌是一个重要的肿瘤学挑战，其发病率使其成为一个重要的健康问题，而且其生物学复杂性使得此类患者的临床结果非常困难。迄今为止，这些疾病不应被视为一个单一的实体，但有必要根据当今对于获得更大治疗效果所必需的特征来区分结直肠癌。这些包括疾病的侧面、微卫星的状态、对目前临床实践中可用的治疗的反应的预后和预测突变的存在，这些都与新的治疗靶点相关。未来最大的挑战将是通过研究具有良好毒性特征的有效联合治疗来规避使这种疾病很难获得良好长期结果的耐药机制。一旦巩固了此类组合或靶向治疗，就需要将最佳疗法转移到一线治疗，以使患者立即可以使用它们。完善可以从这些治疗中受益的患者的选择也至关重要。版权所有 © 2023 Cherri、Oneda、Zanotti 和 Zaniboni。

Colorectal cancer represents an important oncological challenge both for its incidence, which makes it an important health problem, and for its biological complexity, which has made clinical results very difficult in terms of outcome for this category of patients. To date these diseases should not be treated as a single entity but it is necessary to distinguish colorectal cancers based on characteristics that nowadays are essential to have greater therapeutic benefits. These include the sideness of the disease, the state of microsatellites, the presence of prognostic and predictive mutations of response to treatments currently available in clinical practice, which are associated with new therapeutic targets. The greatest challenge in the future will be to circumvent the resistance mechanisms that make this disease very difficult to treat with good long-term results by studying effective combination treatments with a good toxicity profile. Once such combinations or targeted treatments are consolidated, it will be desirable to shift the best therapies to the first line treatment to make them immediately accessible to the patient. It will also be essential to refine the selection of patients who can benefit from these treatments.Copyright © 2023 Cherri, Oneda, Zanotti and Zaniboni.