New trends in molecular and cellular biomarker discovery for colorectal cancer

Abstract

Colorectal cancer (CRC) is the third leading cause of cancer death worldwide, which is consequence of multistep tumorigenesis of several genetic and epigenetic events. Since CRC is mostly asymptomatic until it progresses to advanced stages, the early detection using effective screening approaches, selection of appropriate therapeutic strategies and efficient follow-up programs are essential to reduce CRC mortalities. Biomarker discovery for CRC based on the personalized genotype and clinical information could facilitate the classification of patients with certain types and stages of cancer to tailor preventive and therapeutic approaches. These cancer-related biomarkers should be highly sensitive and specific in a wide range of specimen(s) (including tumor tissues, patients' fluids or stool). Reliable biomarkers which enable the early detection of CRC, can improve early diagnosis, prognosis, treatment response prediction, and recurrence risk. Advances in our understanding of the natural history of CRC have led to the development of different CRC associated molecular and cellular biomarkers. This review highlights the new trends and approaches in CRC biomarker discovery, which could be potentially used for early diagnosis, development of new therapeutic approaches and follow-up of patients.

Keywords: Biomarkers; Cancer diagnosis; Cancer therapy; Colorectal cancer; Predictive marker; Prognostic marker.

Figure 1

Different classes of colorectal cancer associated molecular and cellular biomarkers.

Figure 2

Schematic view of biomarker secretion during different stages of colorectal cancer development (blood and stool biomarkers) (A) and pipelines of biomarker discovery for colorectal cancer (B).

Figure 3

Genes associated to colorectal cancer development. Dysregulation of these genes as a single or in cooperation (due to the DNA mutation, epigenetic changes or as a consequence of change in the regulatory upstream genes/pathways), has been shown in different forms and stages of colorectal cancer.

Figure 4

Genes which are involved in the telomere maintenance and telomerase activity pathway. Any dysregulation in those genes will lead to the pathologic telomere length dynamics during colorectal cancer development stages.