Related Experiment Video
Updated: Sep 6, 2025
Detection of a Circulating MicroRNA Custom Panel in Patients with Metastatic Colorectal Cancer
Published on: March 14, 2019
Prognostic and predictive molecular biomarkers in advanced colorectal cancer
Valentino Martelli1, Alessandro Pastorino1, Alberto F Sobrero1
1Medical Oncology Unit 1, Ospedale Policlinico San Martino - IRCCS, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
Abstract:
The revolution of precision medicine has produced unprecedented seismic shifts in the treatment paradigm of advanced cancers. Among the major killers, colorectal cancer (CRC) is far behind the others. In fact, the great successes obtained in breast, NSCLC, melanoma, and genitourinary tract tumors have been observed only in fewer than 5 % metastatic colorectal cancer (mCRC): those with the mismatch repair deficiency (dMMR), a well-known predictive factor for to the outstanding efficacy of checkpoint inhibitors (CPI). The treatment of the remaining vast majority mCRC patients is still based upon only two molecular determinants: the RAS and BRAF mutational status. New promising biomarkers include HER2, tumor mutational burden (TMB) for its possible implications on CPI efficacy, and the extremely rare NTRK fusions. The Consensus Molecular Subtypes classification (CMS) is a good example of the efforts to combine different molecular features of this disease, although its relevance in clinical practice is still under investigation. In this Review, we focus on all these prognostic and predictive biomarkers, analyzing data from the most important clinical trials of the last years. We also try to rank them according to their prognostic and predictive power.
Insights
Precision medicine advances cancer treatment, but metastatic colorectal cancer (mCRC) lags behind. This review examines key biomarkers like mismatch repair deficiency (dMMR) and RAS/BRAF mutations to improve mCRC patient outcomes.
Area of Science:
- Oncology
- Precision Medicine
- Molecular Diagnostics
Background:
- Advanced cancers, including colorectal cancer (CRC), are increasingly treated with precision medicine.
- Metastatic colorectal cancer (mCRC) has seen limited success with targeted therapies compared to other cancers.
- Current mCRC treatment relies on mismatch repair deficiency (dMMR), RAS, and BRAF mutational status.
Purpose of the Study:
- To review prognostic and predictive biomarkers for metastatic colorectal cancer (mCRC).
- To analyze clinical trial data for key biomarkers in mCRC treatment.
- To rank biomarkers based on their prognostic and predictive power in mCRC.
Main Methods:
- Literature review of recent clinical trials in advanced cancers.
- Analysis of prognostic and predictive biomarkers in metastatic colorectal cancer (mCRC).
- Evaluation of biomarkers including dMMR, RAS, BRAF, HER2, tumor mutational burden (TMB), NTRK fusions, and Consensus Molecular Subtypes (CMS).
Main Results:
- Mismatch repair deficiency (dMMR) predicts response to checkpoint inhibitors (CPI) in a small subset of mCRC.
- RAS and BRAF mutations are primary determinants for the majority of mCRC patients.
- Emerging biomarkers like HER2, TMB, NTRK fusions, and CMS classification show potential but require further clinical validation.
Conclusions:
- Precision medicine offers significant promise for advanced cancers, with ongoing efforts to optimize mCRC treatment.
- Identifying and ranking prognostic and predictive biomarkers is crucial for advancing mCRC patient care.
- Further research and clinical validation are needed to fully integrate novel biomarkers into routine mCRC management.
More Related Videos
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
07:59Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Related Concept Videos
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...