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Review
. 2016:12:141-150.
doi: 10.1007/s11888-016-0312-y. Epub 2016 Apr 18.

Molecular Subtypes and Personalized Therapy in Metastatic Colorectal Cancer

Donna M Graham  1 , Vicky M Coyle  1 , Richard D Kennedy  1 , Richard H Wilson  1
Affiliations
Review

Molecular Subtypes and Personalized Therapy in Metastatic Colorectal Cancer

Donna M Graham et al. Curr Colorectal Cancer Rep. 2016.

Abstract

Development of colorectal cancer occurs via a number of key pathways, with the clinicopathological features of specific subgroups being driven by underlying molecular changes. Mutations in key genes within the network of signalling pathways have been identified; however, therapeutic strategies to target these aberrations remain limited. As understanding of the biology of colorectal cancer has improved, this has led to a move toward broader genomic testing, collaborative research and innovative, adaptive clinical trial design. Recent developments in therapy include the routine adoption of wider mutational spectrum testing prior to use of targeted therapies and the first promise of effective immunotherapy for colorectal cancer patients. This review details current biomarkers in colorectal cancer for molecular stratification and for treatment allocation purposes, including open and planned precision medicine trials. Advances in our understanding, therapeutic strategy and technology will also be outlined.

Keywords: BRAF; Biomarker stratification; Colorectal cancer; EGFR; HER2; Microsatellite instability; Molecular subtypes; Pathways; Personalized medicine trials; RAS; Targeted therapy; c-MET.

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Figures

Fig. 1
Fig. 1
a Genetic models of CRC: i. Chromosomal Instability; ii. Mutator phenotype. Stepwise carcinogenesis occurs due to differing molecular changes in each model. b Resulting core genomic subtypes by molecular subtyping. MMR mismatch repair, CIN chromosomal instability, MSS microsatellite stable, MSI microsatellite instable
See this image and copyright information in PMC

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