Recent developments in the treatment of metastatic colorectal cancer
Over the past decade there have been significant advances in the molecular characterization of colorectal cancer (CRC) that are driving treatment decisions. Expanded RAS testing beyond KRAS exon 2 was established as crucial for identifying patients who will respond to anti-epidermal growth factor re...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2017-08-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/1758834017714997 |
| _version_ | 1818042326099951616 |
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| author | Jonathan M. Loree Scott Kopetz |
| author_facet | Jonathan M. Loree Scott Kopetz |
| author_sort | Jonathan M. Loree |
| collection | DOAJ |
| description | Over the past decade there have been significant advances in the molecular characterization of colorectal cancer (CRC) that are driving treatment decisions. Expanded RAS testing beyond KRAS exon 2 was established as crucial for identifying patients who will respond to anti-epidermal growth factor receptor (EGFR) therapies and low-frequency mutations in RAS /tumor heterogeneity are gaining recognition as potential mechanisms of resistance. Despite this progress, the fact that we do not understand why left-sided but not right-sided tumors have improved outcomes following anti-EGFR therapy highlights our superficial understanding of this disease. Even with few new targeted agents receiving approval in CRC, the incorporation of next-generation sequencing into clinical decision making represents an important step forward. Biomarkers such as BRAF mutations, microsatellite instability, and HER2 amplification represent promising molecular aberrations with therapies in various stages of development, and highlight the importance of companion diagnostics in supporting targeted agents. In this review, we will discuss the importance of incorporating biomarkers into clinical decision making and regimen selection in CRC. We will particularly focus on the recent evidence suggesting an important role for tumor location in selecting first-line therapy, the importance of recent advances in biomarker development and molecular subtyping, as well as recently approved agents (regorafenib and TAS-102) and promising targeted agents that have the potential to change the standard of care. |
| first_indexed | 2024-12-10T08:44:32Z |
| format | Article |
| id | doaj.art-ee17258c2a4a417b8a02e8e5882749d1 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-12-10T08:44:32Z |
| publishDate | 2017-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-ee17258c2a4a417b8a02e8e5882749d12022-12-22T01:55:46ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592017-08-01910.1177/1758834017714997Recent developments in the treatment of metastatic colorectal cancerJonathan M. LoreeScott KopetzOver the past decade there have been significant advances in the molecular characterization of colorectal cancer (CRC) that are driving treatment decisions. Expanded RAS testing beyond KRAS exon 2 was established as crucial for identifying patients who will respond to anti-epidermal growth factor receptor (EGFR) therapies and low-frequency mutations in RAS /tumor heterogeneity are gaining recognition as potential mechanisms of resistance. Despite this progress, the fact that we do not understand why left-sided but not right-sided tumors have improved outcomes following anti-EGFR therapy highlights our superficial understanding of this disease. Even with few new targeted agents receiving approval in CRC, the incorporation of next-generation sequencing into clinical decision making represents an important step forward. Biomarkers such as BRAF mutations, microsatellite instability, and HER2 amplification represent promising molecular aberrations with therapies in various stages of development, and highlight the importance of companion diagnostics in supporting targeted agents. In this review, we will discuss the importance of incorporating biomarkers into clinical decision making and regimen selection in CRC. We will particularly focus on the recent evidence suggesting an important role for tumor location in selecting first-line therapy, the importance of recent advances in biomarker development and molecular subtyping, as well as recently approved agents (regorafenib and TAS-102) and promising targeted agents that have the potential to change the standard of care.https://doi.org/10.1177/1758834017714997 |
| spellingShingle | Jonathan M. Loree Scott Kopetz Recent developments in the treatment of metastatic colorectal cancer Therapeutic Advances in Medical Oncology |
| title | Recent developments in the treatment of metastatic colorectal
cancer |
| title_full | Recent developments in the treatment of metastatic colorectal
cancer |
| title_fullStr | Recent developments in the treatment of metastatic colorectal
cancer |
| title_full_unstemmed | Recent developments in the treatment of metastatic colorectal
cancer |
| title_short | Recent developments in the treatment of metastatic colorectal
cancer |
| title_sort | recent developments in the treatment of metastatic colorectal cancer |
| url | https://doi.org/10.1177/1758834017714997 |
| work_keys_str_mv | AT jonathanmloree recentdevelopmentsinthetreatmentofmetastaticcolorectalcancer AT scottkopetz recentdevelopmentsinthetreatmentofmetastaticcolorectalcancer |