Distant Metastasis in Colorectal Cancer Patients—Do We Have New Predicting Clinicopathological and Molecular Biomarkers? A Comprehensive Review
Abstract
:1. Introduction
2. Tumor Heterogeneity in Colorectal Cancer
3. Sidedness of the Primary Tumor
4. The Cancer Stem Cell Model
5. Distant Metastasis-Related Biomarkers in Clinical Practice
6. Side Effects and Toxicity
7. Drug Resistance in mCRC
8. Experience in Predicting Markers
9. Conclusions and Future Perspectives
Author Contributions
Funding
Conflicts of Interest
References
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Biomarkers | Clinical Relevance | Therapy Benefit | Without Benefit on Therapy | References |
---|---|---|---|---|
Tumor sidedness | Predictive Prognostic |
|
| [55,137,138,139] |
|
| |||
ctDNA | Predictive Prognostic |
| - | [140,141,142,143,144,145,146,147,148,149,150,151,152,153,154] |
| ||||
Tumor burden | Predictive Prognostic |
| - | [155,156,157] |
ALK, ROS1, NTRK1-3 fusions | Predictive |
| - | [158,159,160] |
HER2 amplification | Predictive | - |
| [161,162,163,164] |
The consensus molecular subtypes of colorectal cancer (CMS) | Prognostic | - | - | [165,166,167,168,169] |
Immunoscore | Prognostic | - | - | [170,171,172,173,174] |
Perspectives | Factors |
---|---|
A. Cancer prevention | Lifestyle risks |
Hereditary cancer identification and management | |
Public education | |
B. Identification of early CRC stages | Screening programs (population coverage) |
Improvement of current tests | |
New low-invasive methods (liquid biopsies) | |
C. New prognostic and predictive markers necessary to distinguish suitable patients for current treatment | Patients suitable for neoadjuvant/adjuvant chemotherapy |
High-risk patients where more aggressive approach is applicable | |
Predictive markers for targeted therapy | |
D. Identification of new molecular targets | Anti-tumor immunity activation |
Epigenetic changes | |
Role of microbiome | |
E. Drug development | New effective molecules against identified targets |
Treatment for larger groups of patients (role of immunotherapy) | |
Reduced toxicity and side effects of the treatment | |
F. Faster implication of actual knowledge to the clinical practice | Clinical trials design improvement |
Cost efficiency vs. clinical efficacy acceptable equilibrium | |
Suspension of treatment, which has not shown efficacy |
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Filip, S.; Vymetalkova, V.; Petera, J.; Vodickova, L.; Kubecek, O.; John, S.; Cecka, F.; Krupova, M.; Manethova, M.; Cervena, K.; et al. Distant Metastasis in Colorectal Cancer Patients—Do We Have New Predicting Clinicopathological and Molecular Biomarkers? A Comprehensive Review. Int. J. Mol. Sci. 2020, 21, 5255. https://doi.org/10.3390/ijms21155255
Filip S, Vymetalkova V, Petera J, Vodickova L, Kubecek O, John S, Cecka F, Krupova M, Manethova M, Cervena K, et al. Distant Metastasis in Colorectal Cancer Patients—Do We Have New Predicting Clinicopathological and Molecular Biomarkers? A Comprehensive Review. International Journal of Molecular Sciences. 2020; 21(15):5255. https://doi.org/10.3390/ijms21155255
Chicago/Turabian StyleFilip, Stanislav, Veronika Vymetalkova, Jiri Petera, Ludmila Vodickova, Ondrej Kubecek, Stanislav John, Filip Cecka, Marketa Krupova, Monika Manethova, Klara Cervena, and et al. 2020. "Distant Metastasis in Colorectal Cancer Patients—Do We Have New Predicting Clinicopathological and Molecular Biomarkers? A Comprehensive Review" International Journal of Molecular Sciences 21, no. 15: 5255. https://doi.org/10.3390/ijms21155255