INTESTINE Vol.22 No.5(9)

Theme Molecular biology of colorectal tumors
Title Colorectal tumor from the viewpoint of molecular biology-issues and future prospects
Publish Date 2018/09
Author Masaaki Miyo Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine
Author Tsunekazu Mizushima Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine
Author Yuichiro Doki Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine
Author Masaki Mori Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine
[ Summary ] The introduction of next generation sequencing for clinical samples and molecular pre-screening programs including circulating tumour DNA analyses with major advances in preclinical models meant that investigators have been able to characterize patterns of co-occurring driver events. They have also been able to identify novel, rare, targetable alterations with potentially higher oncogenic dependency, understand the dynamics of target inhibition to design more rational drug combinations and recognize that temporal heterogeneity and clonal selection can explain resistance to matched targeted agents in colorectal cancer (CRC). Thanks to these dramatic improvements in gene analysis technology, colorectal cancers can be divided into four gene expression categories based on biologically distinct consensus molecular subtypes (CMS). CMS from CRC is expected to provide clinicians with informal concerning prognoses, therapeutic responses, and potential novel therapeutic strategies. However, CMS usage presents some problems including ethical issues for genetic examination, security of genetic information and necessity of a unified approach for genetic analyses. Precision medicine for CRC based on CMS must be developed.
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