Profiling Colorectal Cancer in the Landscape Personalized Testing—Advantages of Liquid Biopsy

Abstract

Drug-specific therapeutic approaches for colorectal cancer (CRC) have contributed to significant improvements in patient health. Nevertheless, there is still a great need to improve the personalization of treatments based on genetic and epigenetic tumor profiles to maximize the quality and efficacy while limiting cytotoxicity. Currently, CEA and CA 19-9 are the only validated blood biomarkers in clinical practice. For this reason, laboratories are trying to identify new specific prognostics and, more importantly, predictive biomarkers for CRC patient profiling. Thus, the unique landscape of personalized biomarker data should have a clinical impact on CRC treatment strategies and molecular genetic screening tests should become the standard method for diagnosing CRC. This review concentrates on recent molecular testing in CRC and discusses the potential modifications in CRC assay methodology with the upcoming clinical application of novel genomic approaches. While mechanisms for analyzing circulating tumor DNA have been proven too inaccurate, detecting and analyzing circulating tumor cells and protein analysis of exosomes represent more promising options. Blood liquid biopsy offers good prospects for the future if the results align with pathologists’ tissue analyses. Overall, early detection, accurate diagnosis and treatment monitoring for CRC with specific markers and targeted molecular testing may benefit many patients.

The bioinformatics and experimental analysis of CD276 for prognosis and immune infiltrates in colon adenocarcinoma

“…The high diagnostic value of CD276 was demonstrated by a ROC curve with an AUC of 0.912 for COAD. Because the existing serum biomarkers lacked high sensitivity and speci city for the surveillance of metastatic or recurrent disease in COAD, it may be signi cant to determine the cut-off value of CD276 and use as a biomarker for early alarming tumor recurrence after surgery [23][24][25]. In addition, the clinical implication of CD276 upregulation in COAD was evaluated.…”

Small Extracellular Vesicles: Key Forces Mediating the Development and Metastasis of Colorectal Cancer

“…(2) sEVs showed advantages far beyond other biomarkers for the diagnosis of CRC. Donatella et al found that sEVs were more sensitive than circulating tumor DNA (ctDNA) and circulating tumor cells (CTC) for the diagnosis of CRC, with higher sensitivity and specificity [ 118 ]. Furthermore, human plasma sEV-derived miRNAs had higher specificity than total plasma miRNAs in the early diagnosis of colon cancer.…”

Circulating Tumor Cells in Colorectal Cancer: Detection Systems and Clinical Utility

“…Recent research papers [ 11 , 12 , 13 ] highlight the need for additional procedures and biomarkers in the field of precision medicine. Future steps in the clinical treatment of metastatic colorectal cancer (mCRC) will include the integration of the comprehensive knowledge of tumor gene alterations, gene expression profiling of the tumor and microenvironment, proteomic research, and host immune capabilities.…”

“…Since radiological and endoscopic imaging techniques have a low level of sensitivity for detecting the micrometastatic process, other diagnostic tools, such as liquid biopsy, are being seriously considered and implemented in the current practice. Liquid biopsies provide the possibility of tumor analysis, which includes protein and DNA/RNA analysis, i.e., molecular profiling after CTC isolation [ 12 , 19 ]. Examples include disseminated tumor cells (DTCs) in the bone marrow and CTCs in the peripheral blood, which are increasingly used as prognostic markers.…”