Title:Genetic Molecular Subtypes in Optimizing Personalized Therapy for Metastatic Colorectal Cancer
Volume: 19
Issue: 15
Author(s): Marcin Włodarczyk*, Jakub Włodarczyk, Paweł Siwiński, Aleksandra Sobolewska-Włodarczyk and Jakub Fichna
Affiliation:
- Department of Biochemistry, Medical University of Lodz, Lodz,Poland
Keywords:
Consensus molecular subtypes, colorectal cancer, chemotherapy, carcinogenesis, chromosomal instability, microsatellite
instability.
Abstract: Colorectal cancer (CRC) is a heterogeneous disease entity in terms of both molecular carcinogenesis
and morphologic carcinogenesis multistep pathways. Considerable heterogeneity exists
within CRC due to the varied genetic and epigenetic mechanisms involved in different carcinogenesis
pathways. A better understanding of pathophysiology of tumors is necessary to develop modern and
successful means of treatment in metastatic CRC. Over the last 5 years, there has been a surge in interest
in the molecular classification of colorectal cancer, as its clinical importance both for predicting
prognosis and in guiding personalized treatment had been acknowledged. Recently, the Colorectal
Cancer Subtyping Consortium identified four consensus molecular subtypes, CMS 1-4 in CRC; however,
attempts to stratify CRC using molecular features for prognostic and predictive purposes in clinical
conditions had limited success. In this review, we focused on molecularly defined subtypes of
CRC including specific mutations and discuss implications for current and future patient management
in metastatic CRC to achieve the maximal therapeutic response for each patient, while reducing adverse
side effects of therapy.
