Clasificarea moleculară a cancerelor colorectale şi importanţa ei clinică - scurt review

Colorectal cancer (CRC) is one of the most common types of cancer, and is characterized by the alte­ra­tion of critical pathways such as: WNT, MAPK, PIK3, epithelial to mesenchymal transition (EMT), hyper­methylation of numerous gene promoters, copy number variation (CNV), all causing genetic and epigenetic instabilities in cells. The differences in these molecular events result in various phenotypic features of CRC, which have been studied and classified in different molecular subtypes. Advances in our understanding of the molecular genetics of CRC has led to the development of biomarkers that are being currently used in diagnostic, prognostic and predicting treatment responses of patients. The most well-known example is the validated testing of metastatic CRC (mCRC) for specific KRAS mutations, in order to select those patients who have the best chance to respond to the monoclonal anti-EGFR therapies such as cetuximab and panitumumab. Obviously, for an extended molecular characterization of the tumor complexity and an individualized treatment, some other biomarkers have to be investigated. In this paper, we review the current knowledge of the most important molecular characteristics of CRC, and how these alterations contribute to a better molecular classification of the disease, in order to improve prognosis and treatment response.