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Updated: Dec 21, 2025
Detection of a Circulating MicroRNA Custom Panel in Patients with Metastatic Colorectal Cancer
Published on: March 14, 2019
Molecular-Biology-Driven Treatment for Metastatic Colorectal Cancer
Eleonora Lai1, Nicole Liscia1,2, Clelia Donisi1
1Medical Oncology Unit, University Hospital and University of Cagliari, 09042 Cagliari, Italy.
Background:
Metastatic CRC (mCRC) is a molecular heterogeneous disease. The aim of this review is to give an overview of molecular-driven treatment of mCRC patients.
Methods:
A review of clinical trials, retrospective studies and case reports was performed regarding molecular biomarkers with therapeutic implications.
Results:
RAS wild-type status was confirmed as being crucial for anti-epidermal growth factor receptor (EGFR) monoclonal antibodies and for rechallenge strategy. Antiangiogenic therapies improve survival in first- and second-line settings, irrespective of RAS status, while tyrosine kinase inhibitors (TKIs) remain promising in refractory mCRC. Promising results emerged from anti-HER2 drugs trials in HER2-positive mCRC. Target inhibitors were successful for BRAF mutant mCRC patients, while immunotherapy was successful for microsatellite instability-high/defective mismatch repair (MSI-H/dMMR) or DNA polymerase epsilon catalytic subunit (POLE-1) mutant patients. Data are still lacking on NTRK, RET, MGMT, and TGF-β, which require further research.
Conclusion:
Several molecular biomarkers have been identified for the tailored treatment of mCRC patients and multiple efforts are currently ongoing to increase the therapeutic options. In the era of precision medicine, molecular-biology-driven treatment is the key to impro patient selection and patient outcomes. Further research and large phase III trials are required to ameliorate the therapeutic management of these patients.
Insights
Molecular biomarkers guide metastatic colorectal cancer treatment. Identifying specific mutations like RAS, BRAF, and MSI-H/dMMR optimizes therapy selection and improves patient outcomes in precision medicine.
Area of Science:
- Oncology
- Molecular Biology
- Genomics
Background:
- Metastatic colorectal cancer (mCRC) is a complex disease with significant molecular diversity.
- Tailored treatment strategies are essential for improving patient outcomes in mCRC.
Purpose of the Study:
- To provide a comprehensive overview of molecularly targeted therapies for patients with mCRC.
- To highlight the role of specific molecular biomarkers in guiding treatment decisions.
Main Methods:
- A systematic review of clinical trials, retrospective studies, and case reports.
- Focus on studies investigating molecular biomarkers with therapeutic implications in mCRC.
Main Results:
- RAS wild-type status is critical for anti-EGFR antibody efficacy and rechallenge strategies.
- Antiangiogenic therapies and TKIs show efficacy in various mCRC settings.
- Immunotherapy is effective for MSI-H/dMMR or POLE-1 mutant mCRC.
- Targeted inhibitors benefit BRAF-mutant mCRC.
- Anti-HER2 drugs show promise in HER2-positive mCRC.
- Further research is needed for NTRK, RET, MGMT, and TGF-β.
Conclusions:
- Molecular biomarkers are crucial for personalized mCRC treatment.
- Precision medicine approaches enhance patient selection and outcomes.
- Ongoing research and clinical trials are vital for advancing mCRC therapeutic options.
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