Annual Review of Systemic Medical Treatment for Colorectal Cancer in 2025

This review summarizes landmark advances in colorectal cancer treatment in 2025, characterizing the transition to dynamic precision oncology. Immunotherapy has revolutionized mismatch repair-deficient or microsatellite instability-high patients, becoming the standard first-line and perioperative regimen. Precision medicine expanded to patients with BRAF V600E, KRAS mutation, and HER2 amplification. While circulating tumor DNA utility was confirmed for surveillance and guiding rechallenge, its role in real-time treatment adjustment continues to be explored.