Molecular Biomarkers for the Evaluation of Colorectal Cancer: Guideline From the American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and American Society of Clinical Oncology

J Mol Diagn. 2017 Mar;19(2):187-225. doi: 10.1016/j.jmoldx.2016.11.001. Epub 2017 Feb 6.

Abstract

Objectives: To develop evidence-based guideline recommendations through a systematic review of the literature to establish standard molecular biomarker testing of colorectal cancer (CRC) tissues to guide epidermal growth factor receptor (EGFR) therapies and conventional chemotherapy regimens.

Methods: The American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and American Society of Clinical Oncology convened an expert panel to develop an evidence-based guideline to establish standard molecular biomarker testing and guide therapies for patients with CRC. A comprehensive literature search that included more than 4,000 articles was conducted.

Results: Twenty-one guideline statements were established.

Conclusions: Evidence supports mutational testing for EGFR signaling pathway genes, since they provide clinically actionable information as negative predictors of benefit to anti-EGFR monoclonal antibody therapies for targeted therapy of CRC. Mutations in several of the biomarkers have clear prognostic value. Laboratory approaches to operationalize CRC molecular testing are presented. Key Words: Molecular diagnostics; Gastrointestinal; Histology; Genetics; Oncology.

Publication types

  • Practice Guideline

MeSH terms

  • Biomarkers, Tumor*
  • Colorectal Neoplasms* / diagnosis
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / genetics
  • Colorectal Neoplasms* / mortality
  • Disease Management
  • Gene Frequency
  • Genomic Instability
  • Humans
  • Meta-Analysis as Topic
  • Molecular Diagnostic Techniques
  • Molecular Targeted Therapy
  • Mutation
  • Mutation Rate
  • Prognosis
  • Signal Transduction
  • Systematic Reviews as Topic
  • Treatment Outcome

Substances

  • Biomarkers, Tumor