title: Translating colorectal cancer genetics into clinically useful biomarkers.
abstract: Colorectal cancer (CRC) is a major health problem worldwide accounting for over a million deaths annually. While many patients with Stage II and III CRC can be cured with combinations of surgery, radiotherapy and chemotherapy, this is morbid costly treatment and a significant proportion will suffer recurrence and eventually die of CRC. Increased understanding of the molecular pathogenesis of CRC has the potential to identify high risk patients and target therapy more appropriately. Despite increased understanding of the molecular events underlying CRC development, established molecular techniques have only produced a limited number of biomarkers suitable for use in routine clinical practice to predict risk, prognosis and response to treatment. Recent rapid technological developments, however, have made genomic sequencing of CRC more economical and efficient, creating potential for the discovery of genetic biomarkers that have greater diagnostic, prognostic and therapeutic capabilities for the management of CRC. This paper reviews the current understanding of the molecular pathogenesis of CRC, and summarizes molecular biomarkers that surgeons will encounter in current clinical use as well as those under development in clinical and preclinical trials. New molecular technologies are reviewed together with their potential impact on the understanding of the molecular pathogenesis of CRC and their potential clinical utility in classification, diagnosis, prognosis and targeting of therapy.
authors.affiliation: Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand.
authors.forename: A
authors.initials: A
authors.lastname: Morley-Bunker
authors.affiliation: Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand.
authors.forename: L C
authors.initials: LC
authors.lastname: Walker
authors.affiliation: Mackenzie Cancer Research Group, Department of Pathology, University of Otago, Christchurch, New Zealand.
authors.forename: M J
authors.initials: MJ
authors.lastname: Currie
authors.affiliation: Biostatistics and Computational Biology Unit, University of Otago, Christchurch, New Zealand.
authors.forename: J
authors.initials: J
authors.lastname: Pearson
authors.affiliation: Department of Surgery, University of Otago, Christchurch, New Zealand. Tim.eglinton@cdhb.health.nz.
authors.forename: T
authors.initials: T
authors.lastname: Eglinton
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D015179:Colorectal Neoplasms / Q000235:genetics*; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics; D019175:DNA Methylation / Q000235:genetics; D053843:DNA Mismatch Repair / Q000235:genetics*; D006801:Humans; D053842:Microsatellite Instability; D009154:Mutation; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor