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Evolving Tissue and Circulating Biomarkers as Prognostic and Predictive Tools in Colorectal Cancer

  • Personalized Medicine in ColorectalCancer (D Cunningham and EC Smyth, Section Editors)
  • Published:
Current Colorectal Cancer Reports

Abstract

Purpose of Review

The success of precision medicine relies heavily on biomarkers. Validated biomarkers that help stratify risk and guide treatments in patients with colorectal cancers are limited. With advances in genomics, immune landscapes and technological assays, there are increasing numbers of biomarkers that show potential to guide treatment decisions in the clinic. In this article, we review the key emerging biomarkers including tissue-based gene-based expression biomarkers, microRNA and immune signatures along with circulating tumour DNA in plasma, biomarkers of anti-angiogenic agents.

Recent Findings

Mismatch repair proteins have emerged as predictive biomarkers of immune-oncology agents. Lack of caudal-type homeobox transcription factor 2 (CDX2) expression has been identified as a potential prognostic biomarker identifying a subgroup of patients with high-risk stage 2 colon cancer who would benefit from adjuvant chemotherapy. A validated biomarker, Immunoscore, has been proposed as an adjunct to the conventional TNM classification to help with prognostication. Circulating tumour DNA has the potential to be a prognostic and predictive biomarker in patients with metastatic colorectal cancer, and by identifying minimal residual disease in stage 2 and 3 colorectal cancer, it can be useful to detect early relapse.

Summary

Biomarker discovery and validation has its own challenges, but to truly deliver precision medicine to our patients, it is crucial to understand and address key research gaps.

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  1. Department of Medicine, Royal Marsden Hospital, Downs Road, Sutton, Surrey, SM2 5PT, UK

    Gayathri Anandappa & Ian Chau

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Gayathri Anandappa and Ian Chau declare they have no conflict of interest. The authors would like to acknowledge the National Health Service funding to the National Institute for Health Research Biomedical Research Centre at the Royal Marsden NHS Foundation Trust and the Institute of Cancer Research.

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Anandappa, G., Chau, I. Evolving Tissue and Circulating Biomarkers as Prognostic and Predictive Tools in Colorectal Cancer. Curr Colorectal Cancer Rep 14, 138–151 (2018). https://doi.org/10.1007/s11888-018-0410-0

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