Colorectal Cancer: Personalized Therapy.

Area of Science:

• Oncology
• Gastroenterology
• Molecular Biology

Background:

• Colorectal cancer (CRC) is a leading cause of cancer globally, with significant advancements in treating metastatic disease.
• Combination chemotherapy and targeted agents have improved survival and curative resection rates.
• Understanding tumorigenesis mechanisms drives personalized medicine through tumor characterization and patient stratification.

Purpose of the Study:

• To review current treatment regimens for colorectal cancer.
• To summarize recent advances in the personalized therapy of CRC.
• To highlight the role of biomarkers in guiding treatment decisions.

Main Methods:

• Analysis of colorectal cancer development pathways (chromosomal instability and microsatellite instability).
• Identification and evaluation of prognostic and predictive biomarkers.
• Review of current clinical guidelines and treatment strategies.

Main Results:

• Microsatellite instability, indicated by defective mismatch repair (dMMR), is a strong positive prognostic factor in resected colon cancer.
• Adjuvant chemotherapy may be omitted in dMMR-positive patients.
• In metastatic CRC, wild-type RAS status predicts response to epidermal growth factor receptor inhibitors, necessitating RAS analysis before first-line therapy.

Conclusions:

• Understanding CRC pathogenesis pathways and biomarkers is crucial for personalized therapy.
• dMMR status influences adjuvant treatment decisions.
• RAS mutation status is essential for guiding first-line metastatic CRC treatment with targeted agents.