Colon Cancer: From Traditional Chemotherapy to Precision Medicine
Colorectal cancer is the second leading cause of cancer death in the U.S. Most cases arise from adenomatous polyps and develop slowly over years, making screening vital for early detection.
Treatment Approaches
- Early-stage disease: Managed with surgery ± adjuvant chemotherapy
- Metastatic disease: Treated with regimens like FOLFOX or FOLFIRI, with targeted agents based on tumor genetics
Biomarkers Guiding Therapy
- RAS wild-type: Eligible for anti-EGFR monoclonal antibodies (cetuximab, panitumumab)
- BRAF V600E: Combination therapy with BRAF/MEK inhibitors (e.g., encorafenib + cetuximab)
- MSI-High/dMMR: Strong predictor of response to immunotherapy (e.g., pembrolizumab)
Future Directions
Liquid biopsies, circulating tumor DNA (ctDNA) for recurrence monitoring, and novel immuno- combinations are being integrated into clinical care.