改善早期结肠癌治疗的需求明显未被满足。本文综述了当前系统性治疗的现状，并总结了创新性和关键性试验。对免疫评分和循环肿瘤DNA（ctDNA）进行研究，以评估哪些患者应接受无、3个月或6个月的辅助治疗。此外，还有几个试验针对标准化疗后未清除ctDNA的患者测试逐步增强的治疗策略。治疗转化为早期结肠癌情况后，已取得针对转移性结肠癌患者的进展。两个正在进行的随机对照试验研究免疫检查点抑制剂（ICI）在微卫星不稳定高（MSI-H）早期结肠癌患者中的作为辅助治疗。新辅助治疗也正在进行几个随机对照试验。在Neo-adjuvant试验中，MSI-H肿瘤患者的完全缓解率具有可能避免器官切除的意义。版权所有©2023作者。由Elsevier B.V.出版。保留所有权利。

There is a clear unmet need to improve early colon cancer management. This review encompasses the current systemic treatment landscape and summarises novel and pivotal trials. The Immunoscore and circulating tumour DNA (ctDNA) are studied to evaluate which patients should receive no, 3, or 6 months of adjuvant treatment. Several trials also test escalating treatment strategies for non-cleared ctDNA following standard adjuvant chemotherapy. Advances made in treating patients with metastatic colon cancer are now being translated to the early colon cancer setting. Two ongoing RCTs study immune checkpoint inhibitors (ICI) in patients with microsatellite instable high (MSI-H) early colon cancer as adjuvant treatment. Neo-adjuvant treatment is being studied in several ongoing RCTs as well. The complete response rate in patients with MSI-H tumours following ICI in neoadjuvant trials has potential organ-sparing implications.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.