Abstract
Pathological diagnosis is essential today for the individualized therapy of colorectal cancer. In the routine analysis of colorectal carcinomas the molecular-pathological detection of a KRAS mutation predicts unresponsiveness to EGFR-targeted antibody therapies. Moreover, the detection of mismatch-repair deficiency or high-degree microsatellite instability indicates unresponsiveness to 5-FU monotherapy. Colorectal carcinomas with high-grade microsatellite instability and their associated morphologic subtypes, such as the medullary carcinoma, exhibit a low risk of distant metastasis and might be considered as carcinomas with low need for adjuvant chemotherapy.
MeSH terms
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents / therapeutic use*
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Cetuximab
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Chemotherapy, Adjuvant
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Colorectal Neoplasms / drug therapy
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Colorectal Neoplasms / genetics*
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Colorectal Neoplasms / pathology*
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Combined Modality Therapy
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DNA Mismatch Repair / genetics
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DNA Mutational Analysis
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Drug Resistance, Neoplasm / genetics
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ErbB Receptors / antagonists & inhibitors
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ErbB Receptors / genetics
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Fluorouracil / adverse effects
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Fluorouracil / therapeutic use
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Gene Expression Profiling
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Gene Expression Regulation, Neoplastic / drug effects
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Gene Expression Regulation, Neoplastic / genetics
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Humans
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Leucovorin / adverse effects
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Leucovorin / therapeutic use
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Microsatellite Instability
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Nerve Tissue Proteins / genetics
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Organoplatinum Compounds / adverse effects
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Organoplatinum Compounds / therapeutic use
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Panitumumab
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Pharmacogenetics
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Practice Guidelines as Topic
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Prognosis
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Proto-Oncogene Proteins / genetics
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Proto-Oncogene Proteins p21(ras)
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RNA-Binding Proteins / genetics
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ras Proteins / genetics
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents
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KRAS protein, human
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MSI1 protein, human
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Nerve Tissue Proteins
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Organoplatinum Compounds
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Proto-Oncogene Proteins
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RNA-Binding Proteins
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Panitumumab
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EGFR protein, human
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ErbB Receptors
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Proto-Oncogene Proteins p21(ras)
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ras Proteins
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Cetuximab
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Leucovorin
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Fluorouracil