{"id":4432,"date":"2025-09-01T21:54:12","date_gmt":"2025-09-01T18:24:12","guid":{"rendered":"https:\/\/gimed.ir\/Colorectal-cancer\/?p=4432"},"modified":"2025-09-01T22:20:03","modified_gmt":"2025-09-01T18:50:03","slug":"first-line-therapy-ras-mut-braf-mut-or-dmmr-msi-h","status":"publish","type":"post","link":"https:\/\/gimed.ir\/Colorectal-cancer\/first-line-therapy-ras-mut-braf-mut-or-dmmr-msi-h\/","title":{"rendered":"First-line Therapy: RAS-mut, BRAF-mut or dMMR\/MSI-H"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"4432\" class=\"elementor elementor-4432\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-595db97 e-flex e-con-boxed e-con e-parent\" data-id=\"595db97\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-0753a0e e-con-full e-flex e-con e-child\" data-id=\"0753a0e\" data-element_type=\"container\">\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5a0a360 e-con-full e-flex e-con e-child\" data-id=\"5a0a360\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-17a31c9 elementor-widget elementor-widget-hotspot\" data-id=\"17a31c9\" data-element_type=\"widget\" data-settings=\"{&quot;hotspot&quot;:[{&quot;_id&quot;:&quot;6490865&quot;,&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-info-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_custom_size&quot;:&quot;&quot;,&quot;hotspot_tooltip_content&quot;:&quot;&lt;p&gt;&lt;b&gt;\\u06f1. \\u062a\\u0639\\u06cc\\u06cc\\u0646 \\u0648\\u0636\\u0639\\u06cc\\u062a \\u0698\\u0646\\u062a\\u06cc\\u06a9\\u06cc&lt;\\\/b&gt;&lt;\\\/p&gt;&lt;ul&gt;&lt;li&gt;\\u0628\\u0631\\u0631\\u0633\\u06cc&lt;b&gt; \\u062c\\u0647\\u0634\\u200c\\u0647\\u0627\\u06cc &lt;\\\/b&gt;&lt;b&gt;RAS&lt;\\\/b&gt; \\u0631\\u0648\\u06cc \\u0646\\u0645\\u0648\\u0646\\u0647 \\u062a\\u0648\\u0645\\u0648\\u0631 \\u0636\\u0631\\u0648\\u0631\\u06cc \\u0627\\u0633\\u062a (I, A).&lt;\\\/li&gt;&lt;li&gt;\\u062f\\u0631 \\u0635\\u0648\\u0631\\u062a \\u0646\\u0628\\u0648\\u062f \\u0646\\u0645\\u0648\\u0646\\u0647 \\u062a\\u0648\\u0645\\u0648\\u0631\\u060c \\u0628\\u0631\\u0631\\u0633\\u06cc \\u0628\\u0627&lt;b&gt; \\u0628\\u06cc\\u0648\\u067e\\u0633\\u06cc \\u0645\\u0627\\u06cc\\u0639 (&lt;\\\/b&gt;&lt;b&gt;Liquid biopsy&lt;\\\/b&gt;&lt;b&gt;)&lt;\\\/b&gt; \\u0627\\u0645\\u06a9\\u0627\\u0646\\u200c\\u067e\\u0630\\u06cc\\u0631 \\u0627\\u0633\\u062a (II, B).&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0639\\u06cc\\u06cc\\u0646 \\u0648\\u0636\\u0639\\u06cc\\u062a \\u0698\\u0646\\u062a\\u06cc\\u06a9\\u06cc \\u0628\\u0631\\u0627\\u06cc \\u0627\\u0646\\u062a\\u062e\\u0627\\u0628 \\u0628\\u0647\\u062a\\u0631\\u06cc\\u0646 \\u062f\\u0631\\u0645\\u0627\\u0646 \\u0627\\u0644\\u0632\\u0627\\u0645\\u06cc \\u0627\\u0633\\u062a.&lt;\\\/li&gt;&lt;\\\/ul&gt;&lt;p&gt;&lt;b&gt;\\u06f2. \\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u062f\\u0631\\u0645\\u0627\\u0646 \\u0633\\u06cc\\u0633\\u062a\\u0645\\u06cc\\u06a9 \\u0648 \\u0628\\u06cc\\u0648\\u0644\\u0648\\u0698\\u06cc\\u06a9&lt;\\\/b&gt;&lt;\\\/p&gt;&lt;p&gt;&lt;b&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u062f\\u0631\\u0645\\u0627\\u0646 \\u0628\\u06cc\\u0648\\u0644\\u0648\\u0698\\u06cc\\u06a9 \\u0628\\u0627 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc&lt;\\\/b&gt; \\u062f\\u0631 \\u062e\\u0637 \\u0627\\u0648\\u0644 \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f\\u060c \\u0645\\u06af\\u0631 \\u0627\\u06cc\\u0646\\u06a9\\u0647 \\u0645\\u0646\\u0639 \\u0645\\u0635\\u0631\\u0641 \\u0648\\u062c\\u0648\\u062f \\u062f\\u0627\\u0634\\u062a\\u0647 \\u0628\\u0627\\u0634\\u062f (I, A).&lt;\\\/p&gt;&lt;p&gt;\\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0628\\u0627\\u06cc\\u062f \\u062f\\u0631 \\u0637\\u0648\\u0644 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u06cc \\u0627\\u0632 \\u062a\\u0645\\u0627\\u0645 \\u06af\\u0632\\u06cc\\u0646\\u0647\\u200c\\u0647\\u0627\\u06cc \\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u0645\\u0648\\u062c\\u0648\\u062f \\u0628\\u0647\\u0631\\u0647\\u200c\\u0645\\u0646\\u062f \\u0634\\u0648\\u0646\\u062f (I, B).&lt;\\\/p&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:57,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:0,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;top&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:409,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;},{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-info-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_custom_size&quot;:&quot;&quot;,&quot;hotspot_tooltip_content&quot;:&quot;&lt;p&gt;&lt;b&gt;\\u06f3. \\u0622\\u0646\\u062a\\u06cc\\u200c\\u0628\\u0627\\u062f\\u06cc\\u200c\\u0647\\u0627\\u06cc \\u0645\\u0648\\u0646\\u0648\\u06a9\\u0644\\u0648\\u0646\\u0627\\u0644&lt;\\\/b&gt;&lt;\\\/p&gt;&lt;ul&gt;&lt;li&gt;&lt;b&gt;\\u0622\\u0646\\u062a\\u06cc-&lt;\\\/b&gt;&lt;b&gt;EGFR&lt;\\\/b&gt; \\u0645\\u06cc\\u200c\\u062a\\u0648\\u0627\\u0646\\u062f \\u0628\\u0627 &lt;b&gt;\\u062f\\u0648\\u0632\\u0647\\u0627\\u06cc \\u062f\\u0648\\u0628\\u0644\\u0647 &lt;\\\/b&gt;&lt;b&gt;FOLFOX &lt;\\\/b&gt;&lt;b&gt;\\u06cc\\u0627 &lt;\\\/b&gt;&lt;b&gt;FOLFIRI&lt;\\\/b&gt; \\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0634\\u0648\\u062f (I, A).&lt;\\\/li&gt;&lt;li&gt;FOLFOX4-\\u067e\\u0627\\u0646\\u06cc\\u062a\\u0648\\u0645\\u0648\\u0645\\u0627\\u0628: &lt;b&gt;\\u0627\\u0645\\u062a\\u06cc\\u0627\\u0632 &lt;\\\/b&gt;&lt;b&gt;ESMO-MCBS v1.1&lt;\\\/b&gt;&lt;b&gt;:&lt;\\\/b&gt;&lt;b&gt; 4&lt;\\\/b&gt;&lt;\\\/li&gt;&lt;li&gt;FOLFIRI-\\u0633\\u06cc\\u062a\\u0648\\u06a9\\u0633\\u06cc\\u0645\\u0627\\u0628: &lt;b&gt;\\u0627\\u0645\\u062a\\u06cc\\u0627\\u0632 &lt;\\\/b&gt;&lt;b&gt;ESMO-MCBS v1.1&lt;\\\/b&gt;&lt;b&gt;:&lt;\\\/b&gt;&lt;b&gt; 4&lt;\\\/b&gt;&lt;\\\/li&gt;&lt;li&gt;&lt;b&gt;\\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628&lt;\\\/b&gt; \\u0645\\u06cc\\u200c\\u062a\\u0648\\u0627\\u0646\\u062f \\u0628\\u0627:&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u06a9 \\u0641\\u0644\\u0648\\u0631\\u067e\\u06cc\\u0631\\u06cc\\u0645\\u06cc\\u062f\\u06cc\\u0646\\u200c\\u0647\\u0627\\u060c \\u0627\\u06cc\\u0631\\u06cc\\u0646\\u0648\\u062a\\u06a9\\u0627\\u0646\\u060c \\u06cc\\u0627 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u062f\\u0648\\u0628\\u0644\\u0647 \\u0645\\u0628\\u062a\\u0646\\u06cc \\u0628\\u0631 \\u0627\\u06a9\\u0633\\u0627\\u0644\\u06cc\\u200c\\u067e\\u0644\\u0627\\u062a\\u06cc\\u0646 (FOLFOX, CAPOX, FOLFIRI) \\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0634\\u0648\\u062f.&lt;\\\/li&gt;&lt;li&gt;CAPOX \\u06cc\\u0627 FOLFOX4\\u2013\\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628: &lt;b&gt;ESMO-MCBS v1.1 score&lt;\\\/b&gt;&lt;b&gt;:&lt;\\\/b&gt;&lt;b&gt; 1&lt;\\\/b&gt;&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0633\\u0647\\u200c\\u06af\\u0627\\u0646\\u0647 FOLFOXIRI\\u2013\\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628: &lt;b&gt;ESMO-MCBS v1.1 score&lt;\\\/b&gt;&lt;b&gt;:&lt;\\\/b&gt;&lt;b&gt; 3&lt;\\\/b&gt;&lt;\\\/li&gt;&lt;\\\/ul&gt;&lt;p&gt;&lt;b&gt;\\u06f4. \\u062a\\u0631\\u06a9\\u06cc\\u0628\\u200c\\u0647\\u0627\\u06cc \\u0633\\u0647\\u200c\\u06af\\u0627\\u0646\\u0647&lt;\\\/b&gt;&lt;\\\/p&gt;&lt;ul&gt;&lt;li&gt;FOLFOXIRI + \\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628 \\u0645\\u06cc\\u200c\\u062a\\u0648\\u0627\\u0646\\u062f \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0628\\u0627 \\u0639\\u0645\\u0644\\u06a9\\u0631\\u062f \\u062e\\u0648\\u0628 \\u0648 \\u0628\\u062f\\u0648\\u0646 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u06cc \\u0647\\u0645\\u0631\\u0627\\u0647 \\u06af\\u0632\\u06cc\\u0646\\u0647\\u200c\\u0627\\u06cc \\u0628\\u0627\\u0634\\u062f (I, B).&lt;\\\/li&gt;&lt;li&gt;\\u0627\\u0633\\u062a\\u0641\\u0627\\u062f\\u0647 \\u0627\\u0632 \\u0633\\u0647\\u200c\\u06af\\u0627\\u0646\\u0647 \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 &gt;\\u06f7\\u06f5 \\u0633\\u0627\\u0644\\u060c \\u0628\\u0627 PS2 \\u06cc\\u0627 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u06cc \\u0647\\u0645\\u0631\\u0627\\u0647 \\u0634\\u062f\\u06cc\\u062f \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0646\\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (IV, E).&lt;\\\/li&gt;&lt;li&gt;\\u0628\\u0631\\u0627\\u06cc \\u0627\\u0647\\u062f\\u0627\\u0641 &lt;b&gt;Downstaging&lt;\\\/b&gt;\\u060c \\u0633\\u0647\\u200c\\u06af\\u0627\\u0646\\u0647 \\u00b1 FOLFOXIRI \\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628 \\u0645\\u06cc\\u200c\\u062a\\u0648\\u0627\\u0646\\u062f \\u0645\\u062f \\u0646\\u0638\\u0631 \\u0628\\u0627\\u0634\\u062f\\u060c \\u0627\\u06af\\u0631\\u0686\\u0647 \\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u062f\\u0648\\u0628\\u0644\\u0647 + \\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628 \\u0646\\u06cc\\u0632 \\u0645\\u0645\\u06a9\\u0646 \\u0627\\u0633\\u062a \\u0646\\u062a\\u0627\\u06cc\\u062c \\u0645\\u0634\\u0627\\u0628\\u0647 \\u062f\\u0647\\u062f (II, B).&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 FOLFOXIRI + \\u0622\\u0646\\u062a\\u06cc-EGFR \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0646\\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (I, D).&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0622\\u0646\\u062a\\u06cc-VEGF + \\u0622\\u0646\\u062a\\u06cc- EGFR \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0646\\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (I, E).&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:57,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:8,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;top&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:409,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;2225031&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;},{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-info-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_custom_size&quot;:&quot;&quot;,&quot;hotspot_tooltip_content&quot;:&quot;&lt;p&gt;&lt;b&gt;\\u06f5. \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 &lt;\\\/b&gt;&lt;b&gt;RAS-&lt;\\\/b&gt;&lt;b&gt;wt&lt;\\\/b&gt; &lt;b&gt;\\u0648 &lt;\\\/b&gt;&lt;b&gt;BRAF-&lt;\\\/b&gt;&lt;b&gt;wt&lt;\\\/b&gt;&lt;\\\/p&gt;&lt;ul&gt;&lt;li&gt;\\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 &lt;b&gt;RAS-&lt;\\\/b&gt;&lt;b&gt;wt&lt;\\\/b&gt;&lt;b&gt; mCRC&lt;\\\/b&gt;\\u060c \\u062e\\u0637 \\u0627\\u0648\\u0644 \\u0634\\u0627\\u0645\\u0644 &lt;b&gt;\\u062f\\u0648\\u0632 \\u062f\\u0648\\u0628\\u0644\\u0647 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc (&lt;\\\/b&gt;&lt;b&gt;FOLFOX, FOLFIRI, CAPOX&lt;\\\/b&gt;&lt;b&gt;)&lt;\\\/b&gt; \\u0647\\u0645\\u0631\\u0627\\u0647 \\u0628\\u0627 &lt;b&gt;Anti-VEGF &lt;\\\/b&gt;&lt;b&gt;\\u06cc\\u0627 &lt;\\\/b&gt;&lt;b&gt;Anti-EGFR&lt;\\\/b&gt; \\u0627\\u0633\\u062a (I, B).&lt;\\\/li&gt;&lt;li&gt;\\u062f\\u0631 &lt;b&gt;\\u062a\\u0648\\u0645\\u0648\\u0631\\u0647\\u0627\\u06cc \\u0633\\u0645\\u062a \\u0686\\u067e &lt;\\\/b&gt;&lt;b&gt;RAS-&lt;\\\/b&gt;&lt;b&gt;wt&lt;\\\/b&gt; &lt;b&gt;\\u0648 &lt;\\\/b&gt;&lt;b&gt;BRAF-&lt;\\\/b&gt;&lt;b&gt;wt&lt;\\\/b&gt;\\u060c \\u06af\\u0632\\u06cc\\u0646\\u0647 \\u062a\\u0631\\u062c\\u06cc\\u062d\\u06cc: \\u062f\\u0648\\u0628\\u0644\\u0647 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc + Anti-EGFR \\u0627\\u0633\\u062a (I, A).&lt;\\\/li&gt;&lt;li&gt;\\u0627\\u0633\\u062a\\u0641\\u0627\\u062f\\u0647 \\u0627\\u0632 \\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0633\\u06cc\\u062a\\u0648\\u06a9\\u0633\\u06cc\\u0645\\u0627\\u0628\\u2013\\u06a9\\u0627\\u067e\\u0633\\u06cc\\u200c\\u062a\\u0627\\u0628\\u06cc\\u0646 \\u06cc\\u0627 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u0628\\u0648\\u0644\\u0648\\u0633 5-FU \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0646\\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (I, E).&lt;\\\/li&gt;&lt;li&gt;\\u062f\\u0631 &lt;b&gt;\\u062a\\u0648\\u0645\\u0648\\u0631\\u0647\\u0627\\u06cc \\u0633\\u0645\\u062a \\u0631\\u0627\\u0633\\u062a &lt;\\\/b&gt;&lt;b&gt;RAS-&lt;\\\/b&gt;&lt;b&gt;wt&lt;\\\/b&gt;\\u060c \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc \\u00b1 \\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628 \\u062a\\u0631\\u062c\\u06cc\\u062d \\u062f\\u0627\\u062f\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (II, B).&lt;\\\/li&gt;&lt;li&gt;\\u062f\\u0631 \\u0635\\u0648\\u0631\\u062a \\u0646\\u06cc\\u0627\\u0632 \\u0628\\u0647 \\u067e\\u0627\\u0633\\u062e \\u0628\\u0627\\u0644\\u0627\\u062a\\u0631 \\u0628\\u0631\\u0627\\u06cc &lt;b&gt;\\u062f\\u0631\\u0645\\u0627\\u0646 \\u062a\\u0628\\u062f\\u06cc\\u0644\\u06cc (&lt;\\\/b&gt;&lt;b&gt;Conversion therapy&lt;\\\/b&gt;&lt;b&gt;)&lt;\\\/b&gt;\\u060c \\u062f\\u0648\\u0628\\u0644\\u0647 + \\u0633\\u06cc\\u062a\\u0648\\u06a9\\u0633\\u06cc\\u0645\\u0627\\u0628 \\u06cc\\u0627 \\u067e\\u0627\\u0646\\u06cc\\u062a\\u0648\\u0645\\u0648\\u0645\\u0627\\u0628 \\u0645\\u06cc\\u200c\\u062a\\u0648\\u0627\\u0646\\u062f \\u0627\\u0633\\u062a\\u0641\\u0627\\u062f\\u0647 \\u0634\\u0648\\u062f (II, C)&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:76,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:35,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;top&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:409,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;f4da9bf&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;},{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-info-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_custom_size&quot;:&quot;&quot;,&quot;hotspot_tooltip_content&quot;:&quot;&lt;ul&gt;&lt;li&gt;&lt;p&gt;&lt;b&gt;\\u06f6. \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 &lt;\\\/b&gt;&lt;b&gt;BRAF-&lt;\\\/b&gt;&lt;b&gt;mut&lt;\\\/b&gt;&lt;\\\/p&gt;&lt;ul&gt;&lt;li&gt;\\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 &lt;b&gt;BRAF-&lt;\\\/b&gt;&lt;b&gt;mut&lt;\\\/b&gt; \\u0648 &lt;b&gt;dMMR&lt;\\\/b&gt;\\u060c &lt;b&gt;\\u0627\\u06cc\\u0645\\u0648\\u0646\\u0648\\u062a\\u0631\\u0627\\u067e\\u06cc \\u062e\\u0637 \\u0627\\u0648\\u0644&lt;\\\/b&gt; \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (I, A).&lt;\\\/li&gt;&lt;li&gt;\\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 &lt;b&gt;BRAF V600E&lt;\\\/b&gt;:&lt;\\\/li&gt;&lt;li&gt;&lt;b&gt;Encorafenib + Cetuximab + mFOLFOX6&lt;\\\/b&gt; \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (I, A; FDA approved)&lt;\\\/li&gt;&lt;li&gt;\\u0627\\u06af\\u0631 \\u0627\\u06cc\\u0646 \\u062a\\u0631\\u06a9\\u06cc\\u0628 \\u0645\\u0645\\u06a9\\u0646 \\u0646\\u0628\\u0627\\u0634\\u062f\\u060c &lt;b&gt;FOLFOX &lt;\\\/b&gt;&lt;b&gt;+&lt;\\\/b&gt; &lt;b&gt;\\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628&lt;\\\/b&gt; \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (II, B).&lt;\\\/li&gt;&lt;li&gt;\\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0628\\u0627 \\u062a\\u0648\\u0645\\u0648\\u0631 \\u0633\\u0645\\u062a \\u0631\\u0627\\u0633\\u062a\\u060c &lt;b&gt;FOLFOXIRI &lt;\\\/b&gt;&lt;b&gt;+&lt;\\\/b&gt; &lt;b&gt;\\u0628\\u0648\\u0627\\u0633\\u06cc\\u0632\\u0648\\u0645\\u0627\\u0628&lt;\\\/b&gt; \\u0645\\u06cc\\u200c\\u062a\\u0648\\u0627\\u0646\\u062f \\u062f\\u0631 \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 \\u0627\\u0646\\u062a\\u062e\\u0627\\u0628\\u200c\\u0634\\u062f\\u0647 \\u0627\\u0633\\u062a\\u0641\\u0627\\u062f\\u0647 \\u0634\\u0648\\u062f (II, B).&lt;\\\/li&gt;&lt;\\\/ul&gt;&lt;\\\/li&gt;&lt;li&gt;\\u00a0&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:57,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:35,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;left&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:409,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;4ff653f&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;},{&quot;hotspot_icon&quot;:{&quot;value&quot;:&quot;fas fa-info-circle&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;hotspot_custom_size&quot;:&quot;&quot;,&quot;hotspot_tooltip_content&quot;:&quot;&lt;ul&gt;&lt;li&gt;&lt;p&gt;&lt;b&gt;\\u06f7. \\u0628\\u06cc\\u0645\\u0627\\u0631\\u0627\\u0646 &lt;\\\/b&gt;&lt;b&gt;dMMR \\\/ MSI-H&lt;\\\/b&gt;&lt;\\\/p&gt;&lt;ul&gt;&lt;li&gt;\\u062f\\u0631 &lt;b&gt;mCRC &lt;\\\/b&gt;&lt;b&gt;\\u0645\\u062a\\u0627\\u0633\\u062a\\u0627\\u062a\\u06cc\\u06a9 &lt;\\\/b&gt;&lt;b&gt;dMMR&lt;\\\/b&gt;&lt;b&gt;\\\/MSI-H&lt;\\\/b&gt;\\u060c &lt;b&gt;Pembrolizumab&lt;\\\/b&gt; \\u0628\\u0647\\u200c\\u0639\\u0646\\u0648\\u0627\\u0646 \\u0627\\u0633\\u062a\\u0627\\u0646\\u062f\\u0627\\u0631\\u062f \\u062e\\u0637 \\u0627\\u0648\\u0644 \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (I, A).&lt;\\\/li&gt;&lt;li&gt;\\u062a\\u0631\\u06a9\\u06cc\\u0628 &lt;b&gt;Nivolumab + Ipilimumab&lt;\\\/b&gt; \\u0646\\u06cc\\u0632 &lt;b&gt;PFS &lt;\\\/b&gt;&lt;b&gt;\\u0628\\u0627\\u0644\\u0627\\u062a\\u0631\\u06cc \\u0646\\u0633\\u0628\\u062a \\u0628\\u0647 \\u0634\\u06cc\\u0645\\u06cc\\u200c\\u062f\\u0631\\u0645\\u0627\\u0646\\u06cc&lt;\\\/b&gt; \\u062f\\u0627\\u0631\\u062f\\u060c \\u0628\\u0627 \\u0639\\u0648\\u0627\\u0631\\u0636 \\u06a9\\u0645\\u062a\\u0631\\u060c \\u0648 \\u0628\\u0647\\u200c\\u0639\\u0646\\u0648\\u0627\\u0646 \\u06af\\u0632\\u06cc\\u0646\\u0647 \\u0627\\u0633\\u062a\\u0627\\u0646\\u062f\\u0627\\u0631\\u062f \\u062a\\u0648\\u0635\\u06cc\\u0647 \\u0645\\u06cc\\u200c\\u0634\\u0648\\u062f (I, A).&lt;\\\/li&gt;&lt;\\\/ul&gt;&lt;\\\/li&gt;&lt;\\\/ul&gt;&quot;,&quot;hotspot_offset_x&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:24,&quot;sizes&quot;:[]},&quot;hotspot_offset_y&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:35,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_position&quot;:&quot;yes&quot;,&quot;hotspot_position&quot;:&quot;right&quot;,&quot;hotspot_tooltip_width&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:409,&quot;sizes&quot;:[]},&quot;hotspot_tooltip_text_wrap&quot;:&quot;yes&quot;,&quot;_id&quot;:&quot;92dafce&quot;,&quot;hotspot_label&quot;:&quot;&quot;,&quot;hotspot_link&quot;:{&quot;url&quot;:&quot;&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;},&quot;hotspot_horizontal&quot;:&quot;right&quot;,&quot;hotspot_vertical&quot;:&quot;top&quot;}],&quot;tooltip_position&quot;:&quot;right&quot;,&quot;hotspot_sequenced_animation&quot;:&quot;no&quot;,&quot;tooltip_trigger&quot;:&quot;click&quot;,&quot;tooltip_animation&quot;:&quot;e-hotspot--fade-in-out&quot;}\" data-widget_type=\"hotspot.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"330\" src=\"https:\/\/gimed.ir\/Colorectal-cancer\/wp-content\/uploads\/2025\/09\/0005.png\" class=\"attachment-large size-large wp-image-4435\" alt=\"\" srcset=\"https:\/\/gimed.ir\/Colorectal-cancer\/wp-content\/uploads\/2025\/09\/0005.png 1147w, https:\/\/gimed.ir\/Colorectal-cancer\/wp-content\/uploads\/2025\/09\/0005-500x206.png 500w, https:\/\/gimed.ir\/Colorectal-cancer\/wp-content\/uploads\/2025\/09\/0005-300x124.png 300w, https:\/\/gimed.ir\/Colorectal-cancer\/wp-content\/uploads\/2025\/09\/0005-768x317.png 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/>\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-6490865  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--soft-beat\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-info-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M256 8C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm0 110c23.196 0 42 18.804 42 42s-18.804 42-42 42-42-18.804-42-42 18.804-42 42-42zm56 254c0 6.627-5.373 12-12 12h-88c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h12v-64h-12c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h64c6.627 0 12 5.373 12 12v100h12c6.627 0 12 5.373 12 12v24z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<p><b>\u06f1. \u062a\u0639\u06cc\u06cc\u0646 \u0648\u0636\u0639\u06cc\u062a \u0698\u0646\u062a\u06cc\u06a9\u06cc<\/b><\/p><ul><li>\u0628\u0631\u0631\u0633\u06cc<b> \u062c\u0647\u0634\u200c\u0647\u0627\u06cc <\/b><b>RAS<\/b> \u0631\u0648\u06cc \u0646\u0645\u0648\u0646\u0647 \u062a\u0648\u0645\u0648\u0631 \u0636\u0631\u0648\u0631\u06cc \u0627\u0633\u062a (I, A).<\/li><li>\u062f\u0631 \u0635\u0648\u0631\u062a \u0646\u0628\u0648\u062f \u0646\u0645\u0648\u0646\u0647 \u062a\u0648\u0645\u0648\u0631\u060c \u0628\u0631\u0631\u0633\u06cc \u0628\u0627<b> \u0628\u06cc\u0648\u067e\u0633\u06cc \u0645\u0627\u06cc\u0639 (<\/b><b>Liquid biopsy<\/b><b>)<\/b> \u0627\u0645\u06a9\u0627\u0646\u200c\u067e\u0630\u06cc\u0631 \u0627\u0633\u062a (II, B).<\/li><li>\u062a\u0639\u06cc\u06cc\u0646 \u0648\u0636\u0639\u06cc\u062a \u0698\u0646\u062a\u06cc\u06a9\u06cc \u0628\u0631\u0627\u06cc \u0627\u0646\u062a\u062e\u0627\u0628 \u0628\u0647\u062a\u0631\u06cc\u0646 \u062f\u0631\u0645\u0627\u0646 \u0627\u0644\u0632\u0627\u0645\u06cc \u0627\u0633\u062a.<\/li><\/ul><p><b>\u06f2. \u062a\u0631\u06a9\u06cc\u0628 \u062f\u0631\u0645\u0627\u0646 \u0633\u06cc\u0633\u062a\u0645\u06cc\u06a9 \u0648 \u0628\u06cc\u0648\u0644\u0648\u0698\u06cc\u06a9<\/b><\/p><p><b>\u062a\u0631\u06a9\u06cc\u0628 \u062f\u0631\u0645\u0627\u0646 \u0628\u06cc\u0648\u0644\u0648\u0698\u06cc\u06a9 \u0628\u0627 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc<\/b> \u062f\u0631 \u062e\u0637 \u0627\u0648\u0644 \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f\u060c \u0645\u06af\u0631 \u0627\u06cc\u0646\u06a9\u0647 \u0645\u0646\u0639 \u0645\u0635\u0631\u0641 \u0648\u062c\u0648\u062f \u062f\u0627\u0634\u062a\u0647 \u0628\u0627\u0634\u062f (I, A).<\/p><p>\u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627\u06cc\u062f \u062f\u0631 \u0637\u0648\u0644 \u0628\u06cc\u0645\u0627\u0631\u06cc \u0627\u0632 \u062a\u0645\u0627\u0645 \u06af\u0632\u06cc\u0646\u0647\u200c\u0647\u0627\u06cc \u062f\u0631\u0645\u0627\u0646\u06cc \u0645\u0648\u062c\u0648\u062f \u0628\u0647\u0631\u0647\u200c\u0645\u0646\u062f \u0634\u0648\u0646\u062f (I, B).<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-2225031  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--soft-beat\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-info-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M256 8C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm0 110c23.196 0 42 18.804 42 42s-18.804 42-42 42-42-18.804-42-42 18.804-42 42-42zm56 254c0 6.627-5.373 12-12 12h-88c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h12v-64h-12c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h64c6.627 0 12 5.373 12 12v100h12c6.627 0 12 5.373 12 12v24z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<p><b>\u06f3. \u0622\u0646\u062a\u06cc\u200c\u0628\u0627\u062f\u06cc\u200c\u0647\u0627\u06cc \u0645\u0648\u0646\u0648\u06a9\u0644\u0648\u0646\u0627\u0644<\/b><\/p><ul><li><b>\u0622\u0646\u062a\u06cc-<\/b><b>EGFR<\/b> \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u0628\u0627 <b>\u062f\u0648\u0632\u0647\u0627\u06cc \u062f\u0648\u0628\u0644\u0647 <\/b><b>FOLFOX <\/b><b>\u06cc\u0627 <\/b><b>FOLFIRI<\/b> \u062a\u0631\u06a9\u06cc\u0628 \u0634\u0648\u062f (I, A).<\/li><li>FOLFOX4-\u067e\u0627\u0646\u06cc\u062a\u0648\u0645\u0648\u0645\u0627\u0628: <b>\u0627\u0645\u062a\u06cc\u0627\u0632 <\/b><b>ESMO-MCBS v1.1<\/b><b>:<\/b><b> 4<\/b><\/li><li>FOLFIRI-\u0633\u06cc\u062a\u0648\u06a9\u0633\u06cc\u0645\u0627\u0628: <b>\u0627\u0645\u062a\u06cc\u0627\u0632 <\/b><b>ESMO-MCBS v1.1<\/b><b>:<\/b><b> 4<\/b><\/li><li><b>\u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628<\/b> \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u0628\u0627:<\/li><li>\u062a\u06a9 \u0641\u0644\u0648\u0631\u067e\u06cc\u0631\u06cc\u0645\u06cc\u062f\u06cc\u0646\u200c\u0647\u0627\u060c \u0627\u06cc\u0631\u06cc\u0646\u0648\u062a\u06a9\u0627\u0646\u060c \u06cc\u0627 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u062f\u0648\u0628\u0644\u0647 \u0645\u0628\u062a\u0646\u06cc \u0628\u0631 \u0627\u06a9\u0633\u0627\u0644\u06cc\u200c\u067e\u0644\u0627\u062a\u06cc\u0646 (FOLFOX, CAPOX, FOLFIRI) \u062a\u0631\u06a9\u06cc\u0628 \u0634\u0648\u062f.<\/li><li>CAPOX \u06cc\u0627 FOLFOX4\u2013\u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628: <b>ESMO-MCBS v1.1 score<\/b><b>:<\/b><b> 1<\/b><\/li><li>\u062a\u0631\u06a9\u06cc\u0628 \u0633\u0647\u200c\u06af\u0627\u0646\u0647 FOLFOXIRI\u2013\u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628: <b>ESMO-MCBS v1.1 score<\/b><b>:<\/b><b> 3<\/b><\/li><\/ul><p><b>\u06f4. \u062a\u0631\u06a9\u06cc\u0628\u200c\u0647\u0627\u06cc \u0633\u0647\u200c\u06af\u0627\u0646\u0647<\/b><\/p><ul><li>FOLFOXIRI + \u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628 \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627 \u0639\u0645\u0644\u06a9\u0631\u062f \u062e\u0648\u0628 \u0648 \u0628\u062f\u0648\u0646 \u0628\u06cc\u0645\u0627\u0631\u06cc \u0647\u0645\u0631\u0627\u0647 \u06af\u0632\u06cc\u0646\u0647\u200c\u0627\u06cc \u0628\u0627\u0634\u062f (I, B).<\/li><li>\u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0627\u0632 \u0633\u0647\u200c\u06af\u0627\u0646\u0647 \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 &gt;\u06f7\u06f5 \u0633\u0627\u0644\u060c \u0628\u0627 PS2 \u06cc\u0627 \u0628\u06cc\u0645\u0627\u0631\u06cc \u0647\u0645\u0631\u0627\u0647 \u0634\u062f\u06cc\u062f \u062a\u0648\u0635\u06cc\u0647 \u0646\u0645\u06cc\u200c\u0634\u0648\u062f (IV, E).<\/li><li>\u0628\u0631\u0627\u06cc \u0627\u0647\u062f\u0627\u0641 <b>Downstaging<\/b>\u060c \u0633\u0647\u200c\u06af\u0627\u0646\u0647 \u00b1 FOLFOXIRI \u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628 \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u0645\u062f \u0646\u0638\u0631 \u0628\u0627\u0634\u062f\u060c \u0627\u06af\u0631\u0686\u0647 \u062a\u0631\u06a9\u06cc\u0628 \u062f\u0648\u0628\u0644\u0647 + \u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628 \u0646\u06cc\u0632 \u0645\u0645\u06a9\u0646 \u0627\u0633\u062a \u0646\u062a\u0627\u06cc\u062c \u0645\u0634\u0627\u0628\u0647 \u062f\u0647\u062f (II, B).<\/li><li>\u062a\u0631\u06a9\u06cc\u0628 FOLFOXIRI + \u0622\u0646\u062a\u06cc-EGFR \u062a\u0648\u0635\u06cc\u0647 \u0646\u0645\u06cc\u200c\u0634\u0648\u062f (I, D).<\/li><li>\u062a\u0631\u06a9\u06cc\u0628 \u0622\u0646\u062a\u06cc-VEGF + \u0622\u0646\u062a\u06cc- EGFR \u062a\u0648\u0635\u06cc\u0647 \u0646\u0645\u06cc\u200c\u0634\u0648\u062f (I, E).<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-f4da9bf  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--soft-beat\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-info-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M256 8C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm0 110c23.196 0 42 18.804 42 42s-18.804 42-42 42-42-18.804-42-42 18.804-42 42-42zm56 254c0 6.627-5.373 12-12 12h-88c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h12v-64h-12c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h64c6.627 0 12 5.373 12 12v100h12c6.627 0 12 5.373 12 12v24z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<p><b>\u06f5. \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 <\/b><b>RAS-<\/b><b>wt<\/b> <b>\u0648 <\/b><b>BRAF-<\/b><b>wt<\/b><\/p><ul><li>\u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 <b>RAS-<\/b><b>wt<\/b><b> mCRC<\/b>\u060c \u062e\u0637 \u0627\u0648\u0644 \u0634\u0627\u0645\u0644 <b>\u062f\u0648\u0632 \u062f\u0648\u0628\u0644\u0647 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc (<\/b><b>FOLFOX, FOLFIRI, CAPOX<\/b><b>)<\/b> \u0647\u0645\u0631\u0627\u0647 \u0628\u0627 <b>Anti-VEGF <\/b><b>\u06cc\u0627 <\/b><b>Anti-EGFR<\/b> \u0627\u0633\u062a (I, B).<\/li><li>\u062f\u0631 <b>\u062a\u0648\u0645\u0648\u0631\u0647\u0627\u06cc \u0633\u0645\u062a \u0686\u067e <\/b><b>RAS-<\/b><b>wt<\/b> <b>\u0648 <\/b><b>BRAF-<\/b><b>wt<\/b>\u060c \u06af\u0632\u06cc\u0646\u0647 \u062a\u0631\u062c\u06cc\u062d\u06cc: \u062f\u0648\u0628\u0644\u0647 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc + Anti-EGFR \u0627\u0633\u062a (I, A).<\/li><li>\u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0627\u0632 \u062a\u0631\u06a9\u06cc\u0628 \u0633\u06cc\u062a\u0648\u06a9\u0633\u06cc\u0645\u0627\u0628\u2013\u06a9\u0627\u067e\u0633\u06cc\u200c\u062a\u0627\u0628\u06cc\u0646 \u06cc\u0627 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u0628\u0648\u0644\u0648\u0633 5-FU \u062a\u0648\u0635\u06cc\u0647 \u0646\u0645\u06cc\u200c\u0634\u0648\u062f (I, E).<\/li><li>\u062f\u0631 <b>\u062a\u0648\u0645\u0648\u0631\u0647\u0627\u06cc \u0633\u0645\u062a \u0631\u0627\u0633\u062a <\/b><b>RAS-<\/b><b>wt<\/b>\u060c \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u00b1 \u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628 \u062a\u0631\u062c\u06cc\u062d \u062f\u0627\u062f\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f (II, B).<\/li><li>\u062f\u0631 \u0635\u0648\u0631\u062a \u0646\u06cc\u0627\u0632 \u0628\u0647 \u067e\u0627\u0633\u062e \u0628\u0627\u0644\u0627\u062a\u0631 \u0628\u0631\u0627\u06cc <b>\u062f\u0631\u0645\u0627\u0646 \u062a\u0628\u062f\u06cc\u0644\u06cc (<\/b><b>Conversion therapy<\/b><b>)<\/b>\u060c \u062f\u0648\u0628\u0644\u0647 + \u0633\u06cc\u062a\u0648\u06a9\u0633\u06cc\u0645\u0627\u0628 \u06cc\u0627 \u067e\u0627\u0646\u06cc\u062a\u0648\u0645\u0648\u0645\u0627\u0628 \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0634\u0648\u062f (II, C)<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-4ff653f  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--soft-beat\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-info-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M256 8C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm0 110c23.196 0 42 18.804 42 42s-18.804 42-42 42-42-18.804-42-42 18.804-42 42-42zm56 254c0 6.627-5.373 12-12 12h-88c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h12v-64h-12c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h64c6.627 0 12 5.373 12 12v100h12c6.627 0 12 5.373 12 12v24z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<ul><li><p><b>\u06f6. \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 <\/b><b>BRAF-<\/b><b>mut<\/b><\/p><ul><li>\u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 <b>BRAF-<\/b><b>mut<\/b> \u0648 <b>dMMR<\/b>\u060c <b>\u0627\u06cc\u0645\u0648\u0646\u0648\u062a\u0631\u0627\u067e\u06cc \u062e\u0637 \u0627\u0648\u0644<\/b> \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f (I, A).<\/li><li>\u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 <b>BRAF V600E<\/b>:<\/li><li><b>Encorafenib + Cetuximab + mFOLFOX6<\/b> \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f (I, A; FDA approved)<\/li><li>\u0627\u06af\u0631 \u0627\u06cc\u0646 \u062a\u0631\u06a9\u06cc\u0628 \u0645\u0645\u06a9\u0646 \u0646\u0628\u0627\u0634\u062f\u060c <b>FOLFOX <\/b><b>+<\/b> <b>\u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628<\/b> \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f (II, B).<\/li><li>\u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0628\u0627 \u062a\u0648\u0645\u0648\u0631 \u0633\u0645\u062a \u0631\u0627\u0633\u062a\u060c <b>FOLFOXIRI <\/b><b>+<\/b> <b>\u0628\u0648\u0627\u0633\u06cc\u0632\u0648\u0645\u0627\u0628<\/b> \u0645\u06cc\u200c\u062a\u0648\u0627\u0646\u062f \u062f\u0631 \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 \u0627\u0646\u062a\u062e\u0627\u0628\u200c\u0634\u062f\u0647 \u0627\u0633\u062a\u0641\u0627\u062f\u0647 \u0634\u0648\u062f (II, B).<\/li><\/ul><\/li><li>\u00a0<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t\t\t<div class=\"e-hotspot elementor-repeater-item-92dafce  e-hotspot--position-right e-hotspot--position-top   e-hotspot--icon\">\n\n\t\t\t\t\t\t\t\t<div class=\"e-hotspot__button e-hotspot--soft-beat\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__icon\"><svg class=\"e-font-icon-svg e-fas-info-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M256 8C119.043 8 8 119.083 8 256c0 136.997 111.043 248 248 248s248-111.003 248-248C504 119.083 392.957 8 256 8zm0 110c23.196 0 42 18.804 42 42s-18.804 42-42 42-42-18.804-42-42 18.804-42 42-42zm56 254c0 6.627-5.373 12-12 12h-88c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h12v-64h-12c-6.627 0-12-5.373-12-12v-24c0-6.627 5.373-12 12-12h64c6.627 0 12 5.373 12 12v100h12c6.627 0 12 5.373 12 12v24z\"><\/path><\/svg><\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"e-hotspot__tooltip  e-hotspot--tooltip-position e-hotspot--fade-in-out \" >\n\t\t\t\t\t\t<ul><li><p><b>\u06f7. \u0628\u06cc\u0645\u0627\u0631\u0627\u0646 <\/b><b>dMMR \/ MSI-H<\/b><\/p><ul><li>\u062f\u0631 <b>mCRC <\/b><b>\u0645\u062a\u0627\u0633\u062a\u0627\u062a\u06cc\u06a9 <\/b><b>dMMR<\/b><b>\/MSI-H<\/b>\u060c <b>Pembrolizumab<\/b> \u0628\u0647\u200c\u0639\u0646\u0648\u0627\u0646 \u0627\u0633\u062a\u0627\u0646\u062f\u0627\u0631\u062f \u062e\u0637 \u0627\u0648\u0644 \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f (I, A).<\/li><li>\u062a\u0631\u06a9\u06cc\u0628 <b>Nivolumab + Ipilimumab<\/b> \u0646\u06cc\u0632 <b>PFS <\/b><b>\u0628\u0627\u0644\u0627\u062a\u0631\u06cc \u0646\u0633\u0628\u062a \u0628\u0647 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc<\/b> \u062f\u0627\u0631\u062f\u060c \u0628\u0627 \u0639\u0648\u0627\u0631\u0636 \u06a9\u0645\u062a\u0631\u060c \u0648 \u0628\u0647\u200c\u0639\u0646\u0648\u0627\u0646 \u06af\u0632\u06cc\u0646\u0647 \u0627\u0633\u062a\u0627\u0646\u062f\u0627\u0631\u062f \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f (I, A).<\/li><\/ul><\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\n\t\t\t<\/div>\n\n\t\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1b24d8a e-con-full e-flex e-con e-child\" data-id=\"1b24d8a\" data-element_type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>\u06f1. \u062a\u0639\u06cc\u06cc\u0646 \u0648\u0636\u0639\u06cc\u062a \u0698\u0646\u062a\u06cc\u06a9\u06cc \u0628\u0631\u0631\u0633\u06cc \u062c\u0647\u0634\u200c\u0647\u0627\u06cc RAS \u0631\u0648\u06cc \u0646\u0645\u0648\u0646\u0647 \u062a\u0648\u0645\u0648\u0631 \u0636\u0631\u0648\u0631\u06cc \u0627\u0633\u062a (I, A). \u062f\u0631 \u0635\u0648\u0631\u062a \u0646\u0628\u0648\u062f \u0646\u0645\u0648\u0646\u0647 \u062a\u0648\u0645\u0648\u0631\u060c \u0628\u0631\u0631\u0633\u06cc \u0628\u0627 \u0628\u06cc\u0648\u067e\u0633\u06cc \u0645\u0627\u06cc\u0639 (Liquid biopsy) \u0627\u0645\u06a9\u0627\u0646\u200c\u067e\u0630\u06cc\u0631 \u0627\u0633\u062a (II, B). \u062a\u0639\u06cc\u06cc\u0646 \u0648\u0636\u0639\u06cc\u062a \u0698\u0646\u062a\u06cc\u06a9\u06cc \u0628\u0631\u0627\u06cc \u0627\u0646\u062a\u062e\u0627\u0628 \u0628\u0647\u062a\u0631\u06cc\u0646 \u062f\u0631\u0645\u0627\u0646 \u0627\u0644\u0632\u0627\u0645\u06cc \u0627\u0633\u062a. \u06f2. \u062a\u0631\u06a9\u06cc\u0628 \u062f\u0631\u0645\u0627\u0646 \u0633\u06cc\u0633\u062a\u0645\u06cc\u06a9 \u0648 \u0628\u06cc\u0648\u0644\u0648\u0698\u06cc\u06a9 \u062a\u0631\u06a9\u06cc\u0628 \u062f\u0631\u0645\u0627\u0646 \u0628\u06cc\u0648\u0644\u0648\u0698\u06cc\u06a9 \u0628\u0627 \u0634\u06cc\u0645\u06cc\u200c\u062f\u0631\u0645\u0627\u0646\u06cc \u062f\u0631 \u062e\u0637 \u0627\u0648\u0644 \u062a\u0648\u0635\u06cc\u0647 \u0645\u06cc\u200c\u0634\u0648\u062f\u060c \u0645\u06af\u0631 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