The Road so Far in Colorectal Cancer Pharmacogenomics: Are We Closer to Individualised Treatment?

Abstract

In recent decades, survival rates in colorectal cancer have improved greatly due to pharmacological treatment. However, many patients end up developing adverse drug reactions that can be severe or even life threatening, and that affect their quality of life. These remain a limitation, as they may force dose reduction or treatment discontinuation, diminishing treatment efficacy. From candidate gene approaches to genome-wide analysis, pharmacogenomic knowledge has advanced greatly, yet there is still huge and unexploited potential in the use of novel technologies such as next-generation sequencing strategies. This review summarises the road of colorectal cancer pharmacogenomics so far, presents considerations and directions to be taken for further works and discusses the path towards implementation into clinical practice.

Pharmacogenetics to Avoid Adverse Drug Reactions

“…In line with this, Simoes et al suggested that chemotherapy-induced toxicity in colorectal cancer is likely complex and multigenic [7]. For this reason, they summarized the pharmacogenomic data on colorectal cancer, including candidate gene approaches, genome wide association studies, and next-generation sequencing studies.…”

Practical Notes on the Current ESMO Consensus Guidelines for the Management of Patients with Metastatic Colorectal Cancer in Resource-Constrained Environments of Low- to Middle-Income Countries

“…It has been reported that of mCRC patients treated with FOLFOX, FOLFIRI, or XELOX, nine in ten will experience at least one adverse drug reaction, and two-thirds will have one or more adverse events during the first line of treatment. Such events and the interventions to resolve them further increase the economic burden on the patient [ 12 ]. In LMICs, the cost of treatment is more often than not borne by the patient, in contrast to patients in upper- and upper-middle-income countries where treatment is covered [ 13 ].…”