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Fundamentals of personalised medicine in colorectal cancer
, 12, 2, 2, 1
Affiliations- Department of Genetics, Wroclaw Medical University, Wroclaw, Poland
- Lower Silesian Oncology Centre in Wroclaw, Poland
open access
Abstract
Personalised treatment which is a dynamically developing branch of medicine, is based on individualisation of diagnostic and therapeutic procedures. Its aim is to optimise treatment by increasing therapy effectiveness, while minimising side effects. It is designed both for patients with a diagnosed hereditary cancer syndrome, as well as those with sporadic cancers. In the case of a diagnosed colorectal cancer, personalised treatment requires patient selection based on predictive factors. This involves determination of the genetic status within the epidermal growth factor receptor (EGFR) signalling pathway, including assessment of the cancer tissue genotype with respect to RAS gene mutations (KRAS, NRAS) and BRAF gene mutations. In patients who do not respond to anti-EGFR targeted therapy, chemotherapy aimed at vascular endothelial growth factor (VEGF) is introduced. In personalised medicine it is also essential to introduce prophylactic and therapeutic measures, both in carriers of germline mutations, and members of their families who have not been diagnosed with this mutation, but who meet family history and clinical criteria of hereditary cancer syndrome.
Abstract
Personalised treatment which is a dynamically developing branch of medicine, is based on individualisation of diagnostic and therapeutic procedures. Its aim is to optimise treatment by increasing therapy effectiveness, while minimising side effects. It is designed both for patients with a diagnosed hereditary cancer syndrome, as well as those with sporadic cancers. In the case of a diagnosed colorectal cancer, personalised treatment requires patient selection based on predictive factors. This involves determination of the genetic status within the epidermal growth factor receptor (EGFR) signalling pathway, including assessment of the cancer tissue genotype with respect to RAS gene mutations (KRAS, NRAS) and BRAF gene mutations. In patients who do not respond to anti-EGFR targeted therapy, chemotherapy aimed at vascular endothelial growth factor (VEGF) is introduced. In personalised medicine it is also essential to introduce prophylactic and therapeutic measures, both in carriers of germline mutations, and members of their families who have not been diagnosed with this mutation, but who meet family history and clinical criteria of hereditary cancer syndrome.
Keywords
personalised medicine; colorectal cancer; hereditary cancer syndrome; germline mutation; somatic mutation; epidermal growth factor EGFR; RAS; BRAF
About this articleTitle
Fundamentals of personalised medicine in colorectal cancer
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Review paper
Pages
52-61
Published online
2021-02-05
Page views
679
Article views/downloads
802
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2021;71(1):52-61.
Keywords
personalised medicine
colorectal cancer
hereditary cancer syndrome
germline mutation
somatic mutation
epidermal growth factor EGFR
RAS
BRAF
Authors
Gabriela Janus-Szymańska
Anna Doraczyńska-Kowalik
Marek Bębenek
Emilia Cisarz
Justyna Gil
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