Molecular pathology of colorectal cancer.

Détails

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Etat: Serval
Version: de l'auteur
ID Serval
serval:BIB_136DCDB2A790
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Molecular pathology of colorectal cancer.
Périodique
Polish Journal of Pathology
Auteur(s)
Bosman F., Yan P.
ISSN
1233-9687 (Print)
ISSN-L
1233-9687
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
65
Numéro
4
Pages
257-266
Langue
anglais
Notes
Publication types: ARTICLE
Résumé
Colorectal cancer (CRC) is one of the most intensively studied cancer types, partly because of its high prevalence but also because of the existence of its precursor lesions, tubular or villous adenomas, and more recently (sessile) serrated adenomas, which can be detected endoscopically and removed. The morphological steps in the adenoma-carcinoma sequence have been elucidated at a molecular level, which has been facilitated by identification of the genes responsible for familial intestinal cancer. However, apart from early detection of familial forms of CRC and its use in genetic counseling, until recently such detailed molecular knowledge has had little impact on clinical management of the disease. This has dramatically changed in the last decade. With drugs specifically targeting the epidermal growth factor receptor (EGFR) having been shown effective in CRC, mechanisms responsible for resistance have been explored. The finding that KRAS mutated cancers do not respond to anti-EGFR treatment has had a profound impact on clinical management and on molecular diagnostics of CRC. Additional genetic tests for mutations in NRAS, BRAF and PIK3CA contribute to determining who to treat, and others will follow. New therapies effective in patients with advanced CRC are under investigation. Remaining burning questions for optimal management are which patients will relapse after resection of the primary tumor and which patients will respond to the standard 5FU-oxaliplatin adjuvant treatment regimen. Predictive tests to address these issues are eagerly awaited. New classifications of CRC, based on molecular parameters, are emerging, and we will be confronted with new subtypes of CRC, for which the definition is based on combinations of gene expression patterns, chromosomal alterations, gene mutations and epigenetic characteristics. This will be instrumental in designing new approaches for therapy but will also be translated into molecular diagnostics. Both will contribute to improved clinical management of CRC.
Pubmed
Web of science
Création de la notice
19/02/2015 14:38
Dernière modification de la notice
03/03/2018 14:01
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