J Appl Biomed 11:115-129, 2013 | DOI: 10.2478/v10136-012-0035-6

Assessing colorectal cancer heterogeneity: one step closer to tailored medicine

Pavel Pitule^1,2,3,*, Miroslava Čedíková^1,2, Vladislav Třeška³, Milena Králíčková^1,2, Václav Liška^2,3

¹ Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic

² Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic

³ Department of Surgery, University Hospital and Medical School, Pilsen, Czech Republic

Many advances in understanding colorectal cancer heterogeneity and its impact on the variability of treatment efficacy have been achieved in recent years. New methods have also been introduced in colorectal cancer diagnosis and early detection, including molecular biology techniques as well as newly developed or improved imaging techniques. We are currently aware of some aspects of colorectal cancer heterogeneity, such as alterations in the epidermal growth factor receptor signalling or the different behaviours of tumours belonging to different genetic and epigenetic subtypes. In the future, greater attention should also be focused on other signalling circuits with the goal to treat patients individually, based on the characteristics of their tumours. This so-called personalised medicine will bring more benefits to patients, without unnecessary adverse side effects. Therefore, all new information regarding colorectal cancer biology brings us one step closer to accomplishing this goal.

Keywords: colorectal cancer; chromosomal instability; microsatellite instability; CpG island methylator phenotype; EGFR pathway; circulating tumour cells; stool DNA

Received: January 2, 2013; Revised: January 28, 2013; Published: July 31, 2013  Show citation