The emerging era of personalized medicine in advanced colorectal cancer

Abstract

Colorectal cancer (CRC) is a genetically heterogeneous disease with its pathogenesis often driven by varying genetic or epigenetic alterations. This has led to a substantial number of patients developing chemoresistance and treatment failure, resulting in a high mortality rate for advanced disease. Deep molecular analysis has allowed for the discovery of key intestinal signaling pathways which impacts colonic epithelial cell fate, and the integral role of the tumor microenvironment on cancer growth and dissemination. Through transitioning pre‐clinical knowledge in research into clinical practice, many potential druggable targets within these pathways have been discovered in the hopes of overcoming the roadblocks encountered by conventional therapies. A personalized approach tailoring treatment according to the histopathological and molecular features of individual tumors can hopefully translate to better patient outcomes, and reduce the rate of recurrence in patients with advanced CRC. Herein, the latest understanding on the molecular science behind CRC tumorigenesis, and the potential treatment targets currently at the forefront of research are summarized.

ECM1 regulates the resistance of colorectal cancer to 5-FU treatment by modulating apoptotic cell death and epithelial-mesenchymal transition induction

“…Colorectal cancer (CRC) is the third leading cause of mortality and accounts for about 9.4% of all types of cancer ( Sung et al, 2021 ). This disease’s lethal character is primarily due to the high rates of chemoresistance and recurrence ( Wu et al, 2022 ). 5-Fluorouracil (5-FU) remains a promising therapy option for CRC.…”

Differences in Clinicopathological Features, P16Ink4a and P57KIP2 Immunohistochemical Expressions, and Survival Between Colorectal Carcinoma in Rectosigmoid and Other Colonic Locations

“…Colorectal carcinoma (CRC) is one of the leading causes of human cancer deaths worldwide [ 1 ]. It is a heterogeneous group of neoplasms rather than a neoplasm with unified criteria; hence, extensive investigation of the unique features of different CRCs is needed to understand the disease better and plan personalized treatments [ 2 ]. One unique criterion of CRCs is the different cancer locations within the colon [ 3 ].…”

Current Targeted Therapy for Metastatic Colorectal Cancer

“…However, a large number of patients experience disease progression even after receiving standard regimens. In the future, personalized medicine, in which drugs and drug combinations are optimized based on each patient’s available data including their genetic and epigenetic features and alterations, will improve the efficacy of treatments, reduce side effects, and benefit cancer patients [ 13 , 14 ].…”