title: Multigene assays in metastatic colorectal cancer.
abstract: Specific genomic colorectal cancer alterations are increasingly linked to prognosis and/or response to specific anticancer agents. The identification of KRAS mutations as markers of resistance to epidermal growth factor receptor (EGFR) inhibitors has paved the way to the interrogation of numerous other markers of resistance to anti-EGFR therapy, such as NRAS, BRAF, and PI3KCA mutations. Other genomic and protein expression alterations have recently been identified as potential targets of treatment or as markers of chemotherapy or targeted-therapy resistance, including ERCC1 expression, c-Met expression, PTEN expression, HER2 amplification, HER3 expression, and rare KRAS mutations. As the number of distinct validated intratumor genomic assays increases, numerous molecular assays will need to be compiled into one multigene panel assay. Several companies and academic centers are now offering multigene assays to patients with metastatic colorectal cancer and other solid tumors. This article discusses the technology behind multigene assays, its limitations, its current advantages, and its potential in the clinical care of metastatic colorectal cancer.
authors.affiliation: From the aCenter for Human Genetics Laboratory, Case Western Reserve University, Cleveland, Ohio; bClinical Molecular Diagnostic Laboratory, Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, California; cFulgent Therapeutics Inc, Temple City, California; and dMedical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California.
authors.forename: Kristin K
authors.initials: KK
authors.lastname: Deeb
authors.forename: Jakub P
authors.initials: JP
authors.lastname: Sram
authors.forename: Hanlin
authors.initials: H
authors.lastname: Gao
authors.forename: Marwan G
authors.initials: MG
authors.lastname: Fakih
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods; D006801:Humans; D009154:Mutation; D009362:Neoplasm Metastasis
chemical_list: D014408:Biomarkers, Tumor