Ibero-American Consensus Review and Incorporation of New Biomarkers for Clinical Practice in Colorectal Cancer

Abstract

Advances in genomic technologies have significantly improved the management of colorectal cancer (CRC). Several biomarkers have been identified in CRC that enable personalization in the use of biologic agents that have shown to enhance the clinical outcomes of patients. However, technologies used for their determination generate massive amounts of information that can be difficult for the clinician to interpret and use adequately. Through several discussion meetings, a group of oncology experts from Spain and several Latin American countries reviewed the latest literature to provide practical recommendations on the determination of biomarkers in CRC based on their clinical experience. The article also describes the importance of looking for additional prognostic biomarkers and the use of histopathology to establish an adequate molecular classification. Present and future of immunotherapy biomarkers in CRC patients are also discussed, together with several techniques for marker determination, including liquid biopsy, next-generation sequencing (NGS), polymerase chain reaction (PCR), and fecal immunohistochemical tests. Finally, the role of Molecular Tumor Boards in the diagnosis and treatment of CRC is described. All of this information will allow us to highlight the importance of biomarker determination in CRC.

Advances in Precision Medicine Approaches for Colorectal Cancer: From Molecular Profiling to Targeted Therapies

“…The identification of RAS mutations or wild-type status (nonmutated) guides the selection of treatment options, reducing the risk of exposing patients to ineffective therapies and unnecessary side effects. 170,171 Microsatellite instability (MSI) and DNA mismatch repair deficiency (dMMR) represent another set of biomarkers with critical implications for treatment. Tumors with high MSI or dMMR are more likely to respond to immune checkpoint inhibitors such as programmed cell death protein 1 (PD-1) inhibitors.…”

“…Integrating RAS mutation testing into the diagnostic workup is crucial to determine whether these therapies are suitable for a patient. The identification of RAS mutations or wild-type status (nonmutated) guides the selection of treatment options, reducing the risk of exposing patients to ineffective therapies and unnecessary side effects. , …”