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Updated: Sep 9, 2025

Detection of a Circulating MicroRNA Custom Panel in Patients with Metastatic Colorectal Cancer
08:12

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Personalized therapy in metastatic colorectal cancer: biomarker-driven use of biologics

Francesco Sullo1, Chiara Gallio1, Laura Matteucci1

  • 1Department of Medical Oncology, IRCCS Istituto Romagnolo per Lo Studio Dei Tumori (IRST) "Dino Amadori" Meldola, Italy.

Expert Opinion on Biological Therapy
|September 4, 2025
PubMed
Abstract

Insights

Precision medicine optimizes metastatic colorectal cancer (mCRC) treatment by targeting molecular alterations like RAS and BRAF. Liquid biopsy aids in monitoring treatment response and detecting resistance for better patient outcomes.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • Metastatic colorectal cancer (mCRC) presents significant mortality challenges globally.
  • Limited long-term survival persists despite therapeutic advancements.
  • Molecular heterogeneity in mCRC necessitates personalized treatment strategies.

Purpose of the Study:

  • To review current and emerging molecular targets in mCRC.
  • To discuss the clinical significance of various biomarkers and rare alterations.
  • To explore the role of liquid biopsy in managing mCRC.

Main Methods:

  • Comprehensive literature review of clinical trials, guidelines, and translational studies.
  • Analysis of molecular targets including RAS, BRAF, HER2, and microsatellite instability.
  • Evaluation of tumor sidedness, EGFR ligand expression, and rare fusions (NTRK, RET, ALK).

Main Results:

  • KRAS G12C inhibitors and HER2-targeted therapies show evolving roles.
  • Liquid biopsy, especially ctDNA, is crucial for monitoring, rechallenge, and resistance detection.
  • Tumor sidedness and specific molecular alterations impact treatment selection.

Conclusions:

  • Personalized treatment is achievable in mCRC through molecular profiling.
  • Overcoming resistance, standardizing assays, and ensuring access are key challenges.
  • Integrating innovative agents with real-time molecular monitoring enhances mCRC management.
Keywords:
BRAF V600EHER2-targeted therapyKRAS G12C inhibitorsMSI-H/dMMRNGSimmunotherapyliquid biopsymetastatic colorectal cancer

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