Colorectal Liver Metastases: Does the Future of Precision Medicine Lie in Genetic Testing?

  • Carlotta Barbon
  • Georgios Antonios Margonis
  • Nikolaos Andreatos
  • Neda Rezaee
  • Kazunari Sasaki
  • Stefan Buettner
  • Christos Damaskos
  • Timothy M. Pawlik
  • Jin He
  • Christopher L. Wolfgang
  • Matthew J. Weiss
Review Article
  • 39 Downloads

Abstract

Colorectal liver metastases (CRLM) present an important clinical challenge in both surgical and medical oncology. Despite improvements in management, survival among patients undergoing resection of CRLM is still very variable and there is a paucity of clinical trial data and reliable biomarkers that could guide prognostic forecasts, treatment selection, and follow-up. Fortunately, recent advances in molecular biology and tumor sequencing have identified a number of critical genetic loci and proliferation markers that may hold the key to understanding the biologic behavior of CRLM; specifically, mutations of KRAS, BRAF, TP53, PIK3CA, APC, expression of Ki-67, and the presence of microsatellite instability appear to have a decisive impact on prognosis and response to treatment in patients with CRLM. While the applicability of genetic biomarkers in everyday clinical practice remains conditional on the development of inexpensive bedside sequencing, targeted therapies, and the conduct of appropriate clinical trials, the promise of personalized treatment may be closer to realization than ever before.

Keywords

Colorectal liver metastases Genetics Precision medicine 

Notes

Author’s Contributions

Carlotta Barbon: conception and design, drafting and critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Georgios Antonios Margonis: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Nikolaos Andreatos: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Neda Rezaee: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Kazunari Sasaki: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Stefan Buettner: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Christos Damaskos: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Timothy M Pawlik: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Jin He: design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Christopher L. Wolfgang: conception and design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

Matthew J. Weiss: conception and design, critically revising the article, final approval of the version to be published, agreement to be accountable for all aspects of the work.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Carlotta Barbon
    • 1
  • Georgios Antonios Margonis
    • 1
  • Nikolaos Andreatos
    • 1
  • Neda Rezaee
    • 1
  • Kazunari Sasaki
    • 1
  • Stefan Buettner
    • 1
  • Christos Damaskos
    • 2
  • Timothy M. Pawlik
    • 3
  • Jin He
    • 1
  • Christopher L. Wolfgang
    • 1
  • Matthew J. Weiss
    • 1
  1. 1.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Second Department of Propedeutic Surgery, “Laiko” General Hospital, Medical SchoolNational and Kapodistrian University of AthensAthensGreece
  3. 3.Department of SurgeryThe Ohio State University Wexner Medical CenterColumbusUSA

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