Molecular Variances Between Right- and Left-sided Colon Cancers
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Purpose of Review
During the past few years, several important clinical and molecular differences have been observed simply based on anatomic tumor location of colorectal cancer. With this review, we aimed to give an updated overview of the recent findings on tumor location as a surrogate of embryological, molecular, and clinical differences that have a direct impact on our daily clinical practice.
Increasing evidence has demonstrated a role for the microbiota in shaping inflammatory environments and promoting CRC growth and spread, and now we know that bacterial phylotypes vary depending on the primary tumor location. Compelling evidence has shown that tumor sidedness has both a strong prognostic and predictive value. In fact, right-sided colon cancers display a markedly worse prognosis compared to left-sided tumors; moreover, it seems that right-sided RAS wild-type metastatic colorectal cancer benefits from bevacizumab-based therapy while left-sided tumors have better outcomes with cetuximab-based treatment in the first-line setting. Since the underlying reasons of these differences are yet unknown, further investigations are warranted in this expanding and relevant field.
In this review, we summarize the actual knowledge on the clinical, microbiome, and molecular differences observed between right- and left-sided colon cancers. We also present an overview of the existing data on the prognostic and predictive impact of tumor sidedness on metastatic colorectal cancer patient outcome.
KeywordsLeft-sided colon cancer Right-sided colon cancer Cetuximab Bevacizumab Microbiota
Compliance with Ethics Standards
Conflict of Interest
Alberto Puccini declares that he has no conflict of interest.
John L. Marshall has received compensation from Genentech/Roche, Amgen, Taiho, Caris Life Sciences, Bayer, and Celgene for service as a consultant.
Mohamed E. Salem declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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