Colorectal Liver Metastases: Does the Future of Precision Medicine Lie in Genetic Testing?

Carlotta Barbon, Georgios Antonios Margonis, Nikolaos Andreatos, Neda Rezaee, Kazunari Sasaki, Stefan Buettner, Christos Damaskos, Timothy M. Pawlik, Jin He, Christopher Wolfgang, Matthew J Weiss

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1286-1296
Number of pages11
JournalJournal of Gastrointestinal Surgery
Volume22
Issue number7
DOIs
StatePublished - Jul 1 2018

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Keywords

  • Colorectal liver metastases
  • Genetics
  • Precision medicine

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Barbon, C., Margonis, G. A., Andreatos, N., Rezaee, N., Sasaki, K., Buettner, S., Damaskos, C., Pawlik, T. M., He, J., Wolfgang, C., & Weiss, M. J. (2018). Colorectal Liver Metastases: Does the Future of Precision Medicine Lie in Genetic Testing? Journal of Gastrointestinal Surgery, 22(7), 1286-1296. https://doi.org/10.1007/s11605-018-3766-1