Redefining Therapeutic Approaches in Colorectal Cancer: Targeting Molecular Pathways and Overcoming Resistance

• Published in: International journal of molecular sciences 2024-12, Vol.25 (23), p.12507
• Main Authors: Duta-Ion, Simona Gabriela, Juganaru, Ioana Ruxandra, Hotinceanu, Iulian Andrei, Dan, Andra, Burtavel, Livia Malina, Coman, Madalin Codrut, Focsa, Ina Ofelia, Zaruha, Andra Giorgiana, Codreanu, Patricia Christina, Bohiltea, Laurentiu Camil, Radoi, Viorica Elena
• Format: Article
• Language: English
• Subjects: Angiogenesis; Antimitotic agents; Antineoplastic agents; Apoptosis; Cancer therapies; Cell cycle; Cell growth; Chemotherapy; Chromosomal Instability; Colorectal cancer; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - genetics; Colorectal Neoplasms - metabolism; Colorectal Neoplasms - pathology; Development and progression; DNA methylation; DNA repair; Drug Resistance, Neoplasm - genetics; Epidermal growth factor; Epigenetic inheritance; FDA approval; Gene amplification; Genes; Genetic aspects; Health aspects; Humans; Kinases; Ligands; Medical prognosis; Metastasis; Microsatellite Instability; Molecular Targeted Therapy; Monoclonal antibodies; Mutation; Signal Transduction - drug effects; Tumor proteins; Tumors; Tyrosine
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms252312507

Colorectal cancer (CRC) arises through a combination of genetic and epigenetic alterations that affect key pathways involved in tumor growth and progression. This review examines the major molecular pathways driving CRC, including Chromosomal Instability (CIN), Microsatellite Instability (MSI), and the CpG Island Methylator Phenotype (CIMP). Key mutations in genes such as APC, KRAS, NRAS, BRAF, and TP53 activate signaling pathways like Wnt, EGFR, and PI3K/AKT, contributing to tumorigenesis and influencing responses to targeted therapies. Resistance mechanisms, including mutations that bypass drug action, remain challenging in CRC treatment. This review highlights the role of molecular profiling in guiding the use of targeted therapies such as tyrosine kinase inhibitors and immune checkpoint inhibitors. Novel combination treatments are also discussed as strategies to improve outcomes and overcome resistance. Understanding these molecular mechanisms is critical to advancing personalized treatment approaches in CRC and improving patient prognosis.