Abstract
Colorectal cancer is the third most common cancer and the second cause of cancer-related deaths. Rectal cancer presents roughly one-third of all colorectal cancer cases and differs from it on both anatomical and molecular levels. While standard treatment of colon cancer patients is radical surgery, rectal cancer is usually treated with pre-operative chemoradiotherapy followed by total mesorectal excision, which requires precise estimation of TNM staging. Unfortunately, stage evaluation is based solely on imaging modalities, and they often do not correlate with postoperative pathological findings. Moreover, approximately half of rectal cancer patients do not respond to such pre-operative therapy, so they are exposed to its toxic effects without any clinical benefit. Thus, biomarkers that could precisely predict pre-operative TNM staging, and especially response to therapy, would significantly advance rectal cancer treatment—but till now, no such biomarker has been identified. In cancer research, microRNAs are emerging biomarkers due to their connection with carcinogenesis and exceptional stability. Circulating miRNAs are promising non-invasive biomarkers that could allow monitoring of a patient throughout the whole therapeutic process. This mini-review aims to summarize the current knowledge on miRNAs and circulating miRNAs involved in the prediction of response to treatment and pre-operative staging in rectal cancer patients.
Highlights
Colorectal cancer (CRC) accounts for about 10% of all solid tumors and is the third most common cancer worldwide and the second leading cause of cancer-related deaths
Given the potential miRNA seem to have to predict CRT response and preoperative staging of rectal cancer patients, this mini-review aims to summarize the current knowledge of miRNAs and circulating miRNAs considered as biomarkers in rectal cancer treatment and discuss their possible use in clinical practice
Rectal cancer differs from colon cancer at both the anatomical and molecular levels, and several studies have shown that they partially differ in terms of their global miRNA profiles
Summary
Colorectal cancer (CRC) accounts for about 10% of all solid tumors and is the third most common cancer worldwide and the second leading cause of cancer-related deaths. Tumors of the rectum—here referred to as “rectal cancer” (RC)—are located up to 15 cm from the anal verge They comprise approximately 40% of all CRC cases, and approximately half of all RC patients are diagnosed in the stage of locally advanced rectal carcinoma (LARC) [1]. LARC treatment is based on neoadjuvant chemoradiotherapy (CRT) with fluoropyrimidines followed by surgical treatment and, eventually, adjuvant chemotherapy Such an approach aims to improve the local control of the disease and to increase the likelihood of radical surgery with the preservation of the anal sphincter without the need of permanent colostomy. Patients with a pathologic complete response (pCR) to therapy have another alternative: They can undergo the “watch and wait” treatment, which implies a non-operative surveillance strategy [6] In this approach, patients usually undergo CRT, but instead of surgery, the course of their disease is closely monitored. Given the potential miRNA seem to have to predict CRT response and preoperative staging of rectal cancer patients, this mini-review aims to summarize the current knowledge of miRNAs and circulating miRNAs considered as biomarkers in rectal cancer treatment and discuss their possible use in clinical practice
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