Laboratory of Cancer Research and Clinical Oncology, Department of Medical Oncology, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
Oncologist. 2010;15(7):699-731. doi: 10.1634/theoncologist.2010-0025. Epub 2010 Jun 28.
Rapidly growing insights into the molecular biology of colorectal cancer (CRC) and recent developments in gene sequencing and molecular diagnostics have led to high expectations for the identification of molecular markers to be used in optimized and tailored treatment regimens. However, many of the published data on molecular biomarkers are contradictory in their findings and the current reality is that no molecular marker, other than the KRAS gene in the case of epidermal growth factor receptor (EGFR)- targeted therapy for metastatic disease, has made it into clinical practice. Many markers investigated suffer from technical shortcomings, resulting from lack of quantitative techniques to capture the impact of the molecular alteration. This understanding has recently led to the more comprehensive approaches of global gene expression profiling or genome-wide analysis to determine prognostic and predictive signatures in tumors. In this review, an update of the most recent data on promising biological prognostic and/or predictive markers, including microsatellite instability, epidermal growth factor receptor, KRAS, BRAF, CpG island methylator phenotype, cytotoxic T lymphocytes, forkhead box P3-positive T cells, receptor for hyaluronic acid-mediated motility, phosphatase and tensin homolog, and T-cell originated protein kinase, in patients with CRC is provided.
结直肠癌(CRC)的分子生物学的快速发展,以及基因测序和分子诊断的最新进展,使人们对识别可用于优化和定制治疗方案的分子标志物抱有很高的期望。然而,许多关于分子生物标志物的已发表数据在研究结果上存在矛盾,目前的现实情况是,除了转移性疾病表皮生长因子受体(EGFR)靶向治疗中 KRAS 基因外,没有其他分子标志物已经进入临床实践。许多被研究的标志物存在技术上的缺陷,这是由于缺乏定量技术来捕捉分子改变的影响。这种理解最近导致了更全面的方法,即进行全基因表达谱或全基因组分析,以确定肿瘤中的预后和预测特征。在这篇综述中,提供了结直肠癌患者中最有希望的生物预后和/或预测标志物的最新数据更新,包括微卫星不稳定性、表皮生长因子受体、KRAS、BRAF、CpG 岛甲基化表型、细胞毒性 T 淋巴细胞、叉头框 P3 阳性 T 细胞、透明质酸介导运动受体、磷酸酶和张力蛋白同系物以及 T 细胞起源蛋白激酶。