Evolution or Revolution in Colorectal Cancer Treatment: Present and Future of New Therapeutic Options. A Narrative Review

Colorectal cancer (CRC) is the third most common malignancy worldwide and the second leading cause of cancer-related deaths, accounting for approximately 10% of all cancer cases. By 2050, CRC incidence is expected to rise substantially, driven by population aging and greater exposure to risk factors in developing countries. Despite advances in medicine and pharmacy, the effectiveness of available treatments remains limited, underscoring the urgent need for innovative therapeutic strategies. This review summarizes and critically evaluates currently available CRC therapies and explores new emerging directions. Particular attention is given to the role of immunotherapy, targeted therapies, nanotechnology-based approaches, metal-based compounds, PROTAC technology, and personalized medicine, with emphasis on their efficacy, safety, accessibility, and mechanisms of drug resistance. In conclusion, surgery and chemotherapy remain the backbone of CRC treatment, but novel therapeutic approaches are reshaping the treatment landscape. Emerging strategies may offer improved patient tolerability and survival outcomes by reducing the occurrence of burdensome adverse effects. Persistent challenges such as drug toxicity, the emergence of resistance mechanisms, and inequalities in access to innovative therapies underscore the need for further translational research. Integrating personalized therapeutic approaches will also be crucial to achieving more effective, safer, and accessible treatment strategies for CRC.