title: [The change of pathology in the era of personalized medicine using the example of discordant KRAS mutational status in metastasized colorectal carcinoma].
abstract: Modern pathology has developed from "omega" to "alpha" and is vital for therapy and follow-up of tumor treatment today. Pathology has a key role as part of personalized medicine. It is possible to intervene therapeutically into the molecular genetic intricacy of tumors by establishing predictive biomarkers with corresponding tumor therapeutic agents.By identifying the KRAS mutational status at the metastasized colorectal carcinoma, a statement about the benefit of an anti-EGFR-therapy can be given, which is nowadays the basis of diagnostic and therapy of this cancer.For a long period of time a high concordance between primary and metastases inside the KRAS status was taken for granted. Meanwhile, there are many studies demonstrating a possibly underestimated high degree of discordance. The identification of discordances might gather a subcollective, which partially holds a KRAS wild type tissue and thereby might respond with a partial remission. Thus, the survival time of these patients and their quality of living could be successfully improved.
authors.affiliation: Institut für Pathologie, Katharinenhospital, Stuttgart, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Hekeler
authors.forename: W G
authors.initials: WG
authors.lastname: Zoller
authors.forename: K H
authors.initials: KH
authors.lastname: Wiedorn
authors.forename: A
authors.initials: A
authors.lastname: Bosse
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000473:pathology; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality / Q000473:pathology*; D003299:Cooperative Behavior; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006801:Humans; D033183:Interdisciplinary Communication; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D057285:Precision Medicine; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins / Q000235:genetics*
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; C512478:EGFR protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins