Toward a personalized treatment of colorectal cancer: Prognostic and predictive factors [Vers un traitement personnalisé du cancer colorectal: Facteurs pronostiques et prédictifs]

摘要

Colorectal cancer (CRC) remains a major public health problem despite the advent of several conventional chemotherapies and targeted therapies. The identification of prognostic factors, and also factors that can predict response to different treatments and their toxicity, has become amajor issue in order to optimize and personalize treatment of CRC patients. Although few molecular factors are validated in the field of CRC prognosis where the TNM classification is the main parameter used in clinical practice, the fact is not true for molecular predictive factors. Several of them are now validated for predicting response to certain treatments (KRAS mutations and anti-EGFR antibodies) and their toxicity (dihydropyrimidine déshydrogenase [DPD] for 5-fluorouracil [5-FU], UDP-glucuronosyltransferase 1A1 [UGT 1A1] polymorphism for irinotecan) and open up the way of personalized treatment of CRC.