PREDICTIVE AND PROGNOSTIC BIOMARKERS FOR PERSONALIZED MEDICINE OF COLORECTAL CANCER
DOI:
https://doi.org/10.18554/acbiobras.v2i1.8654Keywords:
Molecular markers, Predictive markers, prognostic markers, 5-FU, Colorectal cancerAbstract
Colorectal cancer (CRC) is the third cancer type in the world. In 2012, it was responsible for 694,000 deaths worldwide. Despite advances in the treatment of CRC, the mortality rate remains high. For this reason, molecular markers approaches could help personalized treatment and increase quality of life and life extension of patients. This study aimed to perform a metaanalysis of the molecular markers in CRC patients. Using english descriptors, linked to Boolean operators (AND / OR), 16 studies, published between 2008 and 2018, were selected from searches of PUBMED, COCHRANE LIBRARY and CLINICAL TRIALS. Our metaanalysis involved 9,114 patients with CRC identified six molecular markers [MMR deficiency (dMMR), TOPO2a+/EGFR-/TP170-, nuclear maspin and Nuclear Cyclin D1a protein expression and DPYD c.1129-5923 C> G / hapB3 variant] as predictive and 10 markers [TP53 mutant, KRAS mutant, expression of miR-326, protein VEGF-D, CatS, ERCC-1, SMAD 4 in MSI and Protein-1 monocyte chemotactic (MCP-1), BRAF V600E/KRAS mutant in tumors with MMR proficiency (pMMR), LGR5 and GUCY2C mRNA expression] as prognosis markers. VEGF-D expression (OR: 2.35 [1.80-3.08]) was the best predictive marker while GUCY2C gene expression was the best CRC prognosis marker (OR: 44.35 [28.75-68.42]). Despite the improvements in CRC treatment and patient outcome at last two decades, only KRAS were introduced clinically as a predictive marker of anti-EGFR therapy. Therefore, clinical validation of new biomarkers is necessary in order to stratify CRC patients at a higher resolution, allowing for optimized treatment.
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