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Tumor Progression02:07

Tumor Progression

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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
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...
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Screening, Prognostic, and Predictive Molecular Tools for Colorectal Cancer: Recent Advances in the Classical

Mihaela Cristina Pavalean1, Ioana Maria Lambrescu1,2, Mihai Ioan Pavalean1

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Molecular tools offer improved colorectal cancer (CRC) detection and risk classification. Biomarkers from tissue, blood, and stool enhance prognosis and guide personalized therapies for better patient outcomes.

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biomarkercolorectal canceremerging biomarkermolecular toolpredictive biomarkerprognostic biomarkerscreening

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Area of Science:

  • Oncology
  • Molecular Biology
  • Biomarker Discovery

Background:

  • Colorectal cancer (CRC) remains a significant global health challenge.
  • Late-stage diagnoses persist despite advancements in screening and treatment.
  • There is a critical need for advanced molecular tools to capture CRC's biological complexity.

Purpose of the Study:

  • To review established and emerging molecular tools for CRC screening, prognosis, and therapeutic prediction.
  • To highlight the potential of novel biomarkers and technologies in precision oncology.
  • To discuss the clinical utility and future directions of molecular diagnostics in CRC management.

Main Methods:

  • Comprehensive literature review of high-throughput technologies and molecular biomarkers.
  • Analysis of evidence from tumor tissue, blood, and stool sample analyses.
  • Examination of biomarkers including DNA mutations, methylation, RNA signatures, ctDNA, cfDNA, extracellular vesicles, and multi-omic assays.

Main Results:

  • Established and emerging molecular tools offer less invasive and more sensitive alternatives to conventional CRC detection.
  • Prognostic biomarkers (e.g., RAS, BRAF, HER2, MMR deficiency, TMB) provide insights into tumor behavior and recurrence risk.
  • Predictive biomarkers (e.g., RAS/BRAF, HER2, MSI-H/dMMR, POLE/POLD1, methylation panels, non-coding RNAs, liquid biopsy markers) are crucial for guiding treatment decisions.

Conclusions:

  • Molecular tools, including multi-omics and AI-driven discovery, are paving the way for precision oncology in CRC.
  • These tools have the potential to revolutionize CRC management through earlier detection and precise predictive capabilities.
  • Large-scale validation and clinical standardization are essential for the widespread adoption of these molecular advancements.