The biological complexity of colorectal cancer: insights into biomarkers for early detection and personalized care.
Colorectal cancer has been ranked the third and second most prevalent of all cancers in men and women, respectively, and it represents the fourth most common cause of cancer deaths. In 2012, there were 1.4 million estimated cases of colorectal cancer worldwide, and 700,000 estimated deaths, which implies significant impact on public health, especially in economically-developed countries. In recent years, there has been an increase in the number of tumors, although this has been accompanied by decreased mortality, due to more appropriate and available information, earlier diagnosis, and improvements in treatment. Colorectal cancers are characterized by great genotypic and phenotypic heterogeneity, including tumor microenvironment and interactions between healthy and cancer cells. All of these traits confer a unique peculiarity to each tumor, which can thus be considered as an individual disease. Well conducted molecular and clinical characterization of each colorectal cancer is essential with a view to the implementation of precision oncology, and thus personalized care. This last aims at standardization of therapeutic plans chosen according to the genetic background of each specific neoplasm, to increase overall survival and reduce treatment side effects. Thus, prognostic and predictive molecular biomarkers assume a critical role in the characterization of colorectal cancer and in the determination of the most appropriate therapy.
Department of Molecular Medicine and Medical Biotechnology, University of Naples 'Federico II ', I-80131 Naples, Italy.
Marina
M
De Rosa
Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, 'Fondazione Giovanni Pascale' IRCCS, I-80131 Naples, Italy.
Daniela
D
Rega
Department of Molecular Medicine and Medical Biotechnology, University of Naples 'Federico II ', I-80131 Naples, Italy.
Valeria
V
Costabile
Department of Molecular Medicine and Medical Biotechnology, University of Naples 'Federico II ', I-80131 Naples, Italy.
Francesca
F
Duraturo
Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, 'Fondazione Giovanni Pascale' IRCCS, I-80131 Naples, Italy.
Antonello
A
Niglio
Department of Molecular Medicine and Medical Biotechnology, University of Naples 'Federico II ', I-80131 Naples, Italy.
Paola
P
Izzo
Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, 'Fondazione Giovanni Pascale' IRCCS, I-80131 Naples, Italy.
Ugo
U
Pace
Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, 'Fondazione Giovanni Pascale' IRCCS, I-80131 Naples, Italy.
Paolo
P
Delrio
colorectal cancer epidemiology; colorectal cancer molecular heterogeneity; colorectal cancer tumorigenesis; predictive biomarkers; prognostic biomarkers