TY - JOUR
T1 - Colorectal Liver Metastases
T2 - Does the Future of Precision Medicine Lie in Genetic Testing?
AU - Barbon, Carlotta
AU - Margonis, Georgios Antonios
AU - Andreatos, Nikolaos
AU - Rezaee, Neda
AU - Sasaki, Kazunari
AU - Buettner, Stefan
AU - Damaskos, Christos
AU - Pawlik, Timothy M.
AU - He, Jin
AU - Wolfgang, Christopher L.
AU - Weiss, Matthew J.
N1 - Funding Information:
Georgios Antonios Margonis was supported by the Bodossaki Foundation
Publisher Copyright:
© 2018, The Society for Surgery of the Alimentary Tract.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Colorectal liver metastases (CRLM) present an important clinical challenge in both surgical and medical oncology. Despite improvements in management, survival among patients undergoing resection of CRLM is still very variable and there is a paucity of clinical trial data and reliable biomarkers that could guide prognostic forecasts, treatment selection, and follow-up. Fortunately, recent advances in molecular biology and tumor sequencing have identified a number of critical genetic loci and proliferation markers that may hold the key to understanding the biologic behavior of CRLM; specifically, mutations of KRAS, BRAF, TP53, PIK3CA, APC, expression of Ki-67, and the presence of microsatellite instability appear to have a decisive impact on prognosis and response to treatment in patients with CRLM. While the applicability of genetic biomarkers in everyday clinical practice remains conditional on the development of inexpensive bedside sequencing, targeted therapies, and the conduct of appropriate clinical trials, the promise of personalized treatment may be closer to realization than ever before.
AB - Colorectal liver metastases (CRLM) present an important clinical challenge in both surgical and medical oncology. Despite improvements in management, survival among patients undergoing resection of CRLM is still very variable and there is a paucity of clinical trial data and reliable biomarkers that could guide prognostic forecasts, treatment selection, and follow-up. Fortunately, recent advances in molecular biology and tumor sequencing have identified a number of critical genetic loci and proliferation markers that may hold the key to understanding the biologic behavior of CRLM; specifically, mutations of KRAS, BRAF, TP53, PIK3CA, APC, expression of Ki-67, and the presence of microsatellite instability appear to have a decisive impact on prognosis and response to treatment in patients with CRLM. While the applicability of genetic biomarkers in everyday clinical practice remains conditional on the development of inexpensive bedside sequencing, targeted therapies, and the conduct of appropriate clinical trials, the promise of personalized treatment may be closer to realization than ever before.
KW - Colorectal liver metastases
KW - Genetics
KW - Precision medicine
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U2 - 10.1007/s11605-018-3766-1
DO - 10.1007/s11605-018-3766-1
M3 - Review article
C2 - 29644557
AN - SCOPUS:85049572831
SN - 1091-255X
VL - 22
SP - 1286
EP - 1296
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 7
ER -