Precision Approaches in the Management of Colorectal Cancer: Current Evidence and Latest Advancements Towards Individualizing the Treatment

The genetic and molecular underpinnings of metastatic colorectal cancer have been studied for decades, and the applicability of these findings in clinical decision making continues to evolve. Advancements in translating molecular studies have provided a basis for tailoring chemotherapeutic regimens...

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Bibliographic Details
Published in:Cancers 2020-11, Vol.12 (11), p.3481
Main Authors: Shuford, Rebecca A, Cairns, Ashley L, Moaven, Omeed
Format: Article
Language:English
Subjects:
Cancer therapies
Care and treatment
Chemotherapy
Colorectal cancer
Colorectal carcinoma
Decision making
Epidermal growth factor
Epidermal growth factor receptors
Fibroblast growth factor 2
Immunotherapy
Metastases
Metastasis
Microsatellite instability
Mismatch repair
Mutation
Out of pocket costs
Patient outcomes
Precision medicine
Review
Sarcoma
Surveillance
Tumors
Vascular endothelial growth factor
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Summary:The genetic and molecular underpinnings of metastatic colorectal cancer have been studied for decades, and the applicability of these findings in clinical decision making continues to evolve. Advancements in translating molecular studies have provided a basis for tailoring chemotherapeutic regimens in metastatic colorectal cancer (mCRC) treatment, which have informed multiple practice guidelines. Various genetic and molecular pathways have been identified as clinically significant in the pathogenesis of metastatic colorectal cancer. These include ( ), epithelial growth factor receptor (EGFR), vascular endothelial growth factor VEGF, microsatellite instability, mismatch repair, and ( ) with established clinical implications. mutations and deficiencies in the mismatch repair pathway guide decisions regarding the administration of anti-EGFR-based therapies and immunotherapy, respectively. Furthermore, there are several emerging pathways and therapeutic modalities that have not entered mainstream use in mCRC treatment and are ripe for further investigation. The well-established data in the arena of targeted therapies provide evidence-based support for the use or avoidance of various therapeutic regimens in mCRC treatment, while the emerging pathways and platforms offer a glimpse into the future of transforming a precision approach into a personalized treatment.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers12113481