Cited by 677Colorectal Cancer Treatments and StudiesGenetic factors in colorectal cancerColorectal Cancer Surgical Treatments

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From tumour heterogeneity to advances in precision treatment of colorectal cancer

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Punt, Cornelis J. A., Koopman, Miriam, Vermeulen, Louis·2017·Nature Reviews Clinical Oncology

DOI 10.1038/nrclinonc.2016.171

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Abstract

In recent years, the high heterogeneity of colorectal cancer (CRC) has become evident. Hence, biomarkers need to be developed that enable the stratification of patients with CRC into different prognostic subgroups and in relation to response to therapies, according to the distinctive tumour biology. Currently, only RAS-mutation status is used routinely as a negative predictive marker to avoid treatment with anti-EGFR agents in patients with metastatic CRC, and mismatch-repair status can guide the use of adjuvant chemotherapy in patients with early stage colon cancer. Advances in molecular biology over the past decade have enabled a better understanding of the development of CRC, as well as the more-precise use of innovative targeted therapies for this disease, and include three fundamental achievements. First, the availability of large databases to capture and store the genomic landscape of patients with CRC, providing information on the genes that are frequently deregulated in CRC. Second, the possibility of using gene-expression profiling to differentiate the subtypes of CRC into prognostic groups. Third, results from highly sensitive next-generation sequencing analyses have led to an appreciation of the extensive intratumoural heterogeneity of CRC. Herein, we discuss these advances and place them into the clinical context, and present the novel targets and therapeutic opportunities that are on the horizon.

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Authors: Punt, C. J. A., Koopman, M., & Vermeulen, L.
Affiliations: Amsterdam UMC Location University of Amsterdam (NL)
University Medical Center Utrecht (NL)
Corresponding author: Punt, Cornelis J. A.
ORCID: Punt, Cornelis J. A.
Koopman, Miriam
Vermeulen, Louis
Venue: Nature Reviews Clinical Oncology
Publisher: Springer Science and Business Media LLC
Published: 2016-12-06
Volume: 14
Issue: 4
Pages: 235-246
ISSN: 1759-4774 (ISSN-L)
1759-4782
DOI: 10.1038/nrclinonc.2016.171
OpenAlex: W2560375214
Cited by: 654
References: 177
Citations by year: 2026: 38 · 2025: 41 · 2024: 87 · 2023: 79 · 2022: 88 · 2021: 96 · 2020: 83 · 2019: 57 · 2018: 56 · 2017: 28
FWCI: 4.73
Type: journal article
Language: en
Open access: green
pure.amsterdamumc.nl
Licence: other-oa
www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Nature Reviews Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion)
Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
Utrecht University Repository (Utrecht University) (submittedVersion)
Funders: Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Maag Lever Darm Stichting (MLDS-CDG 14-03)
H2020 European Research Council (638193)
Topics: Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
Keywords: colorectal cancer, intratumoral heterogeneity, precision medicine, targeted therapy, gene expression profiling, tumor subtypes, prognostic factors, predictive biomarkers, RAS mutations, DNA mismatch repair, anti-EGFR therapy, adjuvant chemotherapy, next-generation sequencing
MeSH terms: Antineoplastic Combined Chemotherapy Protocols, Forecasting, Humans, Immunotherapy, Neoplasm Metastasis, Neoplasm Proteins, Neoplasm Staging, Prognosis, Quality of Health Care, Colorectal Neoplasms, Treatment Outcome, Genetic Heterogeneity, Therapies, Investigational, Proto-Oncogene Proteins B-raf, DNA Mismatch Repair, Early Detection of Cancer, Precision Medicine, Molecular Targeted Therapy

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From tumour heterogeneity to advances in precision treatment of colorectal cancer

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