Biomarkers as a Therapeutic Approach in Colorectal Carcinoma

Abstract

This review highlights the most promising biomarker tests of tumor tissue from colonoscopy biopsy for more individualized therapeutic approaches to patients with colorectal carcinoma (CRC). Biomarkers are a key tool in early detection, survival, and predicting treatment response and prognostic value. The tests can help doctors to select a specific CRC treatment and targeted therapy. CRC is the third most common cancer diagnosed, and the second leading cause of cancer-related deaths worldwide, despite the progress made in detection and management through surgery, chemotherapy, radiotherapy, and immunotherapy. With a population totaling 273,523,621 people, Indonesia has estimated 396,914 new cases of all cancer and 234,511 cancer-related deaths. Among those cancer cases, estimated 34,189 new CRC cases and 17,786 CRC deaths occurred in 2020. Most of CRC cases were located in the rectum compared to those in the distal colon or proximal colon. CRC is a heterogeneous cancer. Its therapeutic approaches vary, depending on the tumor location (proximal, distal colon, or rectum), clinical signs and symptoms, staging and biomarkers such as KRAS and NRAS, BRAF V600E, MSI high (dMMR), CIN, HER2-amplified, PD-1, CTLA-4, MEK, and NTRK gene fusion-positive. CSCs and other biomarkers are being developed and remain under investigation.