title: Intratumoral molecular or genetic markers as predictors of clinical outcome with chemotherapy in colorectal cancer.
abstract: Identification of molecular markers at either the intragenic, chromosomal, mRNA, or protein level that might predict whether colorectal cancer patients are likely to benefit from adjuvant or palliative therapy is a high priority. The majority of clinical studies addressing this issue, particularly those done in the adjuvant setting, analyzed tumor samples from patients treated in the era when 5-fluorouracil (5-FU) alone or combined with leucovorin or levamisole were the mainstay of therapy. This review highlights some of the intratumoral molecular markers that may have importance as predictors of benefit with 5-FU-based therapy. Although the goal of these investigations is to one day permit selection of therapy for an individual patient based on the tumor phenotype, prospective studies have yet to be conducted that test whether selection of therapy based on molecular markers results in an improved outcome.
authors.affiliation: Department of Internal Medicine, Section of Oncology/Hematology, and the Eppley Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA. jgrem@unmc.edu
authors.forename: Jean L
authors.initials: JL
authors.lastname: Grem
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000378:metabolism; D005472:Fluorouracil / Q000627:therapeutic use*; D016158:Genes, p53; D011905:Genes, ras; D042822:Genomic Instability; D006801:Humans; D000077146:Irinotecan; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D011355:Prodrugs / Q000627:therapeutic use; D013940:Thymidylate Synthase / Q000378:metabolism
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D011355:Prodrugs; D000077150:Oxaliplatin; D000077146:Irinotecan; D042943:Dihydrouracil Dehydrogenase (NADP); D013940:Thymidylate Synthase; D005472:Fluorouracil; D002166:Camptothecin