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Are Gene Signatures Ready for Use in the Selection of Patients for Adjuvant Treatment?

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

Abstract

Fluoropyrimidine-based chemotherapy improves survival in stage III colon cancer patients in the adjuvant setting, whereas its clinical benefit in stage II is limited. Adjuvant therapy could be considered in patients with high-risk stage II disease, who are more likely to benefit from chemotherapy. Clinicopathological factors have been routinely used for risk stratification in stage II, as well as microsatellite instability (MSI) analysis, which has been recently incorporated in clinical guidelines as a prognostic marker. Other molecular markers, such as KRAS and BRAF mutations, suggested improving accuracy in prognostic classification in non-metastatic disease. Recent data derived from randomized clinical trial demonstrated that KRAS/BRAF gene mutations are associated with worse outcome depending on MSI status and tumor localization. Similarly, supervised gene expression signatures have refined recurrence risk stratification in several prospective studies although the clinical utility is still debatable. In this review, we focus on the new data on molecular and gene expression profiling in non metastatic colon cancer and the impact on prognostication and treatment decision.

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Author information

Authors and Affiliations

  1. Department of Medical Oncology, Catalan Institute of Oncology (ICO), Av. Gran Via de L’Hospitalet, 199-203, L’Hospitalet de Llobregat, 08908, Barcelona, Spain

    Cristina Santos Vivas, Julieta Grasselli, Nuria Mulet-Margalef & Ramon Salazar Soler

  2. Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Av. Gran Via de L’Hospitalet, 199-203, L’Hospitalet de Llobregat, 08908, Barcelona, Spain

    Rebeca Sanz-Pamplona

  3. Department of Medical Oncology, Vall d’Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Pg. Vall d’Hebron, 119, Barcelona, 08035, Spain

    Julieta Grasselli

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  1. Cristina Santos Vivas
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Correspondence to Ramon Salazar Soler.

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This article is part of the Topical Collection on Personalized Medicine in Colorectal Cancer

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Vivas, C.S., Sanz-Pamplona, R., Grasselli, J. et al. Are Gene Signatures Ready for Use in the Selection of Patients for Adjuvant Treatment?. Curr Colorectal Cancer Rep 12, 18–26 (2016). https://doi.org/10.1007/s11888-016-0305-x

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  • DOI: https://doi.org/10.1007/s11888-016-0305-x

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