Abstract
Colorectal cancer (CRC) is a leading cause of death worldwide, despite progress made in detection and management through surgery, chemotherapy, radiotherapy, and immunotherapy. Novel therapeutic agents have improved survival in both the adjuvant and advanced disease settings, albeit with an increased risk of toxicity and cost. However, metastatic disease continues to have a poor long-term prognosis and significant challenges remain due to late stage diagnosis and treatment failure. Biomarkers are a key tool in early detection, prognostication, survival, and predicting treatment response. The past three decades have seen advances in genomics and molecular pathology of cancer biomarkers, allowing for greater individualization of therapy with a positive impact on survival outcomes. Clinically useful predictive biomarkers aid clinical decision making, such as the presence of KRAS gene mutations predicting benefit from epidermal growth factor receptor (EGFR) inhibiting antibodies. However, few biomarkers have been translated into clinical practice highlighting the need for further investigation. We review a range of protein, DNA and RNA-based biomarkers under investigation for diagnostic, predictive, and prognostic properties for CRC. In particular, long non-coding RNAs (lncRNA), have been investigated as biomarkers in a range of cancers including colorectal cancer. Specifically, we evaluate the potential role of lncRNA plasmacytoma variant translocation 1 (PVT1), an oncogene, as a diagnostic, prognostic, and therapeutic biomarker in colorectal cancer.
Highlights
Epidemiology, Burden of Disease and Challenges in Treatment & ChemoresistanceColorectal cancer (CRC) is the fourth most common cancer overall worldwide contributing to 9.7% of global cancer burden [1,2,3,4,5]
Molecular subtyping of colorectal cancer has led to several categories of potential biomarkers through somatic mutations, germline pharmacogenomics, cancer stem cells, microRNA, and long non-coding RNA [10,56,62,63]
The determination of Kirsten rat sarcoma viral oncogene (KRAS), BRAF, and microsatellite instability (MSI) status has become an indispensable step in therapeutic planning, especially in patients with metastatic disease
Summary
Colorectal cancer (CRC) is the fourth most common cancer overall worldwide contributing to 9.7% of global cancer burden [1,2,3,4,5]. It affects 746,000 men (10% of all cancer cases) and 614,000 women (9.2% of all cancer cases) with most cases (55%) occurring in developed countries [3,6]. The incidence of colorectal cancer increased between 1991 and 2016 and is attributed to lifestyle, environmental changes, and aging populations [7,8]. CRC remains a prevalent challenge in cancer management emphasizing the need for early diagnosis
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