title: Molecular Subtypes and Personalized Therapy in Metastatic Colorectal Cancer.
abstract: Development of colorectal cancer occurs via a number of key pathways, with the clinicopathological features of specific subgroups being driven by underlying molecular changes. Mutations in key genes within the network of signalling pathways have been identified; however, therapeutic strategies to target these aberrations remain limited. As understanding of the biology of colorectal cancer has improved, this has led to a move toward broader genomic testing, collaborative research and innovative, adaptive clinical trial design. Recent developments in therapy include the routine adoption of wider mutational spectrum testing prior to use of targeted therapies and the first promise of effective immunotherapy for colorectal cancer patients. This review details current biomarkers in colorectal cancer for molecular stratification and for treatment allocation purposes, including open and planned precision medicine trials. Advances in our understanding, therapeutic strategy and technology will also be outlined.
authors.affiliation: Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE N. Ireland UK.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Graham
authors.affiliation: Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE N. Ireland UK.
authors.forename: Vicky M
authors.initials: VM
authors.lastname: Coyle
authors.affiliation: Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE N. Ireland UK.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Kennedy
authors.affiliation: Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE N. Ireland UK.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Wilson
keywords: BRAF; Biomarker stratification; Colorectal cancer; EGFR; HER2; Microsatellite instability; Molecular subtypes; Pathways; Personalized medicine trials; RAS; Targeted therapy; c-MET