Colorectal cancer is cancer that starts in the colon or the rectum. The major histologic subtype of colorectal cancer is adenocarcinoma which arise through acquisition of a series of mutations in different genes (as shown in the pie chart). These genes serve as a prognostic or predictive marker for targeted therapies available in colorectal cancer.
Molecular Subtype in Colorectal Adenocarcinoma
The targeted agents (anti-EGFR monoclonal antibodies cetuximab and panitumumab) alone or in combination with chemotherapy are current standard of treatment for metastatic colorectal cancer. However, tumours harbouring mutations in KRAS, NRAS and BRAF are unlikely to respond to this anti-EGFR antibody therapy. These mutations were suggested to be a negative predictor of response to anti-EGFR therapy. Therefore, NCCN guideline recommends testing of KRAS, NRAS and BRAF mutations in patients with metastatic colorectal cancer prior to the use of EGFR antibody agents cetuximab and panitumumab[2-5].
Oncode offers range of next-generation sequencing (NGS) panels for colorectal cancer from smaller panel like Colon LiquidPinpoint panel to comprehensive panels.
Table 1: 28 genes mutation panel
Table 2: 67 genes mutation panel
1. Chan, E. (2016). Molecular Profiling of Colorectal Cancer. My Cancer Genome. READ MORE.
2. De Roock, W., Biesmans, B., De Schutter, J. & Teipar, S. (2009). Clinical Biomarkers in Oncology: Focus On Colorectal Cancer. Molecular Diagnosis & Therapy 13(2): 103-14.
3. National Comprehensive Cancer Network (2017). Colon Cancer. NCCN Guidelines for Patients. READ MORE
4. Punt, C.J, Koopman, M. & Vermeulen, L. (2017). From Tumour Heterogeneity to Advances in Precision Treatment of Colorectal Cancer. Nature Reviews Clinical Oncology 14(4):235-246. doi: 10.1038/nrclinonc.2016.171.
5. Rizzo, S. et. al. (2010). Prognostic vs Predictive Molecular Biomarkers in Colorectal Cancer: is KRAS and BRAF Wild Type Status Required for Anti-EGFR Therapy? Cancer Treatment Reviews 36 Suppl 3: S56-61.