Consequently, trying to reduce platinum drug resistance and discovering new antitumor agents are considered areas of future development.Ĭis-diamminedichloroplatinum(II), commonly called cisplatin, was the first platinum derivative successfully used as an anticancer agent against a wide range of tumor types.
However, the efficacy of oxaliplatin is limited due to its systemic toxicity and tumor-resistance to treatment. First-line chemotherapy in advanced CRC with metastasis is based on the use of oxaliplatin in combination with other drugs, namely 5-fluorouracil, leucovorin, and capecitabine. Īs aforementioned, the choice of treatment in CRC depends on the tumor features, and often, a combination of surgical resection and chemotherapy is selected. Whereas a tumor at stage 0 is easily removed by surgical extraction, patients with stage II disease and beyond need a combination of surgery, chemotherapy, and/or radiotherapy to enhance the success of treatment. Poor prognosis is directly related with an advanced stage, as are therapeutic approaches. ĭepending on the grade of local invasion depth, involvement of lymph nodes, and metastasization, CRC can be divided into five stages: 0, I, II, III, and IV, with stage 0 being the earliest and IV the most advanced one. In line with this, most of the cases of CRC are detected in Western countries and its incidence is growing alarmingly due to inadequate dietary patterns, tobacco smoking, and sedentarism, among other factors. Regarding 70% of the total cases of CRC, tumor onset is closely related to age, certain diseases, and lifestyle. Depending on the origin of the mutation, colorectal carcinomas can be classified as sporadic (70%), inherited (5%), and familiar (25%). CRC develops as a result of the change in normal colonic epithelium to adenomatous polyps due to mutations that target oncogenes, tumor suppressor genes, and genes related to DNA repair mechanisms. Herein, we have reviewed the most recent advances in the use of gold(I) derivatives and gold nanoparticles in CRC therapy.Ĭolorectal cancer (CRC) is the third most common type of cancer and has become one of the leading causes of death from cancers worldwide.
Moreover, the use of gold nanoparticles has enhanced the effect of traditional therapies such as radiotherapy, photothermal therapy, or photodynamic therapy, and has displayed a potential role in diagnosis as a consequence of their optic properties. Gold nanoparticles have been found to be able to overcome multidrug resistance along with reduced side effects due to a more efficient uptake of classic drugs. Moreover, given the huge potential of gold nanoparticles, the role of gold in CRC chemotherapy is not limited to gold(I) complexes. Gold(I) derivatives are a promising alternative to platinum complexes, since instead of interacting with DNA, they target proteins overexpressed on tumor cells, thus leading to less side effects than, but a comparable antitumor effect to, platinum derivatives. In addition, tumor resistance to oxaliplatin is related to chemotherapy failure. Classic chemotherapy against CRC is based on oxaliplatin and other cisplatin analogues however, platinum-based therapy lacks selectivity to cancer cells and leads to deleterious side effects. Due to the increasing incidence and high mortality associated with colorectal cancer (CRC), novel therapeutic strategies are urgently needed.