Stratified medicine in colorectal cancer: Current state and challenges ahead


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Sabine Tejpar1
1Digestive Oncology and Center for Human Genetics, University Hospital Leuven, Leuven, Belgium

Abstract

Colorectal cancer is very heterogeneous disease, possibly even different diseases hitting the same organ. This has huge implications for clinical practice and the development of anti cancer drugs in this disease. Only two biomarkers for colorectal cancer are currently sufficiently validated for the clinic. Efforts to find genetic patterns that distinguish between tumours with good or poor prognosis or between patients who do or don’t responder to various therapies are proceeding slowly but steadily. We will discuss various approaches, using cell lines, mouse models, and patient tumors, that can provide key information. Key examples will be discussed, such as the identification of response signatures to EGFR inhibitors in colon cancer, or understanding the role of oncogenic BRAF in this disease, to highlight both gains and gaps in our knowledge. We will also discuss how lack of knowledge hampers current drug development and the challenges faced by both pharma and academia in developing successful trials , balancing biomarker identification and validation in this disease.