title: Colorectal Cancer Classification and Cell Heterogeneity: A Systems Oncology Approach.
abstract: Colorectal cancer is a heterogeneous disease that manifests through diverse clinical scenarios. During many years, our knowledge about the variability of colorectal tumors was limited to the histopathological analysis from which generic classifications associated with different clinical expectations are derived. However, currently we are beginning to understand that under the intense pathological and clinical variability of these tumors there underlies strong genetic and biological heterogeneity. Thus, with the increasing available information of inter-tumor and intra-tumor heterogeneity, the classical pathological approach is being displaced in favor of novel molecular classifications. In the present article, we summarize the most relevant proposals of molecular classifications obtained from the analysis of colorectal tumors using powerful high throughput techniques and devices. We also discuss the role that cancer systems biology may play in the integration and interpretation of the high amount of data generated and the challenges to be addressed in the future development of precision oncology. In addition, we review the current state of implementation of these novel tools in the pathological laboratory and in clinical practice.
authors.affiliation: Translational Cancer Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), As Xubias, 84, 15006 A Coruña, Spain. Moises.Blanco.Calvo@sergas.es.
authors.forename: Moisés
authors.initials: M
authors.lastname: Blanco-Calvo
authors.affiliation: Translational Cancer Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), As Xubias, 84, 15006 A Coruña, Spain. Angel.Concha.Lopez@sergas.es.|Pathology Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), As Xubias, 84, 15006 A Coruña, Spain. Angel.Concha.Lopez@sergas.es.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Concha
authors.affiliation: Translational Cancer Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), As Xubias, 84, 15006 A Coruña, Spain. Angelica.Figueroa.Conde-Valvis@sergas.es.
authors.forename: Angélica
authors.initials: A
authors.lastname: Figueroa
authors.affiliation: Departamento de Bioquímica, Biología Molecular III e Inmunología, Facultad de Medicina, Universidad de Granada, Avenida de Madrid, s/n, 18012 Granada, Spain. federico.garrido.sspa@juntadeandalucia.es.|UGC de Labortorio Clínico, Hospital Universitario Virgen de las Nieves, Servicio de Análisis Clínicos, Avenida de las Fuerzas Armadas, 2, 18009 Granada, Spain. federico.garrido.sspa@juntadeandalucia.es.|Instituto de Investigacion Biosanitaria de Granada (IBISGranada), Avenida de las Fuerzas Armadas, 2, 18009 Granada, Spain. federico.garrido.sspa@juntadeandalucia.es.
authors.forename: Federico
authors.initials: F
authors.lastname: Garrido
authors.affiliation: Translational Cancer Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), As Xubias, 84, 15006 A Coruña, Spain. Manuel.Valladares.Ayerbes@sergas.es.|Medical Oncology Department, Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), As Xubias, 84, 15006 A Coruña, Spain. Manuel.Valladares.Ayerbes@sergas.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Valladares-Ayerbes
mesh_terms: D000818:Animals; D063646:Carcinogenesis / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D060965:Clonal Evolution; D015179:Colorectal Neoplasms / Q000145:classification / Q000378:metabolism / Q000473:pathology*; D015972:Gene Expression Regulation, Neoplastic; D018740:Genetic Heterogeneity; D006801:Humans; D049490:Systems Biology
keywords: cancer systems biology; classification; colorectal cancer; heterogeneity; molecular pathology; precision medicine; targeted therapy