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Colorectal Liver Metastases: Does the Future of Precision Medicine Lie in Genetic Testing?

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Colorectal liver metastases (CRLM) present an important clinical challenge in both surgical and medical oncology. Despite improvements in management, survival among patients undergoing resection of CRLM is still very variable and there is a paucity of clinical trial data and reliable biomarkers that could guide prognostic forecasts, treatment selection, and follow-up. Fortunately, recent advances in molecular biology and tumor sequencing have identified a number of critical genetic loci and proliferation markers that may hold the key to understanding the biologic behavior of CRLM; specifically, mutations of KRAS, BRAF, TP53, PIK3CA, APC, expression of Ki-67, and the presence of microsatellite instability appear to have a decisive impact on prognosis and response to treatment in patients with CRLM. While the applicability of genetic biomarkers in everyday clinical practice remains conditional on the development of inexpensive bedside sequencing, targeted therapies, and the conduct of appropriate clinical trials, the promise of personalized treatment may be closer to realization than ever before.

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Carlotta Barbon: conception and design, drafting and critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Georgios Antonios Margonis: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Nikolaos Andreatos: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Neda Rezaee: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Kazunari Sasaki: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Stefan Buettner: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Christos Damaskos: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Timothy M Pawlik: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Jin He: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Christopher L. Wolfgang: conception and design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Matthew J. Weiss: conception and design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Corresponding author

Correspondence to Matthew J. Weiss.

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Georgios Antonios Margonis was supported by the Bodossaki Foundation

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Barbon, C., Margonis, G.A., Andreatos, N. et al. Colorectal Liver Metastases: Does the Future of Precision Medicine Lie in Genetic Testing?. J Gastrointest Surg 22, 1286–1296 (2018). https://doi.org/10.1007/s11605-018-3766-1

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