Tumor genetic profile is necessary to guide the selection of chemotherapy. Cancer biomarkers help to select surgical treatment. What are KRAS and NRAS mutations? What is the meaning of Microsatellite Instability (MSI)? How to predict response to treatment and prognosis in colorectal cancer?
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Colorectal cancer precision medicine. Dr. David J. Kerr, MD. Tumor biomarkers help to choose best treatment. Dr. Anton Titov, MD. Colorectal cancer personalized medicine targeted chemotherapy options. Leading colorectal cancer expert from Oxford discusses recent advances in colon cancer molecular profiling. Precision medicine in advanced stage 4 colon cancer EGFR targeted chemotherapy. KRAS NRAS in selection of colon cancer patients for targeted chemotherapy. Microsatellite instability (MSI) affects prognosis in colon cancer. How to avoid unnecessary toxicity in colon cancer chemotherapy by tumor molecular markers use. Second opinion confirms that colorectal cancer diagnosis is correct and complete. Dr. Anton Titov, MD. Second opinion also confirms that cure of colon cancer is possible even in advanced colon cancer. Best treatment for advanced stage 4 colon cancer with metastatic lesions. Second opinion helps to choose precision medicine and the best targeted chemotherapy treatment for stage 4 colorectal cancer with liver or lung metastases. Dr. Anton Titov, MD. Get second opinion on advanced colorectal cancer and be confident that your treatment is the best. Best colorectal cancer treatment center for personalized medicine. Dr. David J. Kerr, MD. Video interview with leading expert in metastatic colorectal cancer treatment from Oxford. Colorectal cancer biomarkers in personalized treatment of colon cancer. Dr. Anton Titov, MD. You are an international authority in precision medicine approach to colon cancer. You specialize also in rectal cancer diagnosis and treatment. How predictive biomarkers help to select colorectal cancer patients? How biomarkers help to match colorectal cancer patients with the correct targeted therapies? Dr. David Kerr, MD (Colon cancer oncologist, Oxford). I find terminology that we use in modern cancer medicine to be interesting. We talk about personalized medicine. It is precision medicine. But, of course, all medical treatment for colorectal cancer is personalized. At the moment we use conventional biochemical indices, patient’s age, performance status. Dr. David J. Kerr, MD. We decide how fit the patient is for cancer therapy. We personalize colorectal cancer treatment. This is not something that’s new. What is new is this. There is increasing adoption of molecular tumor markers. Precision medicine allows us to select and segment colorectal cancer patients. They would benefit most from particular therapy of colon cancer or rectal cancer. This is best seen with EGFR inhibitors, Epidermal Growth Factor Receptor pathway inhibitors. We look for mutated KRAS gene. Sometimes a patient has a mutant KRAS oncogene. This colon cancer patient will not respond to EGFR inhibitor. Therefore, testing for KRAS mutation prevents needlessly treating 35% to 40% of colorectal cancer patients. Their tumors are mutant KRAS positive. Dr. David J. Kerr, MD. We have to focus targeted colon cancer therapy on those patients who would benefit most from such treatment. All patients and health economy would benefit from molecular markers use in precision medicine. We use in Oxford other conventional molecular markers in colorectal cancer diagnosis and treatment. We use microsatellite instability (MSI). Dr. Anton Titov, MD. Patients may have early-stage colorectal cancer. There is also a stage 2 and Stage 3 colon cancer after surgical operation. Pathologists give oncologists information about DNA mismatch repair deficiency in resected colorectal tumors. Dr. David J. Kerr, MD. We know MSI proficiency (microsatellite instability, MSI). Colorectal cancer patients that have microsatellite instability in tumors have really good prognosis. We tend not to give them adjuvant chemotherapy, especially in Stage 2 colorectal cancer. This is example of conventional predictive biomarkers. They are used daily in treatment of colorectal cancer. Dr. Anton Titov, MD. Predictive biomarkers also help colorectal cancer patients to avoid unnecessary treatment. You just mentioned this about tumors with microsatellite instability. Avoiding unnecessary toxic chemotherapy is important. Chemotherapy has no proven benefit in certain colon cancer patients. Avoiding chemotherapy can increase quality of life of patients. Dr. David J. Kerr, MD.That is very important. Colorectal cancer precision medicine. Tumor biomarkers are important to select best treatment for colon cancer patient. KRAS, NRAS, BRAF tumor biomarkers.