Stool and blood biomarkers for colorectal cancer management: an update on screening and disease monitoring.

IF 27.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY
Alessandro Mannucci, Ajay Goel
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引用次数: 0

Abstract

Background: Biomarkers have revolutionized the management of colorectal cancer (CRC), facilitating early detection, prevention, personalized treatment, and minimal residual disease (MRD) monitoring. This review explores current CRC screening strategies and emerging biomarker applications.

Main body: We summarize the landscape of non-invasive CRC screening and MRD detection strategies, discuss the limitations of the current approaches, and highlight the promising potential of novel biomarker solutions. The fecal immunochemical test remained the cornerstone of CRC screening, but its sensitivity has been improved by assays that combined its performance with other stool analytes. However, their sensitivity for advanced adenomas and the patient compliance both remain suboptimal. Blood-based tests promise to increase compliance but require further refinement to compete with stool-based biomarker tests. The ideal scenario involves leveraging blood tests to increase screening participation, and simultaneously promote stool- and endoscopy-based screening among those who are compliant. Once solely reliant on upfront surgery followed by stage and pathology-driven adjuvant chemotherapy, the treatment of stage II and III colon cancer has undergone a revolutionary transformation with the advent of MRD testing after surgery. A decade ago, the concept of using a post-surgical test instead of stage and pathology to determine the need for adjuvant chemotherapy was disruptive. Today, a blood test may be more informative of the need for chemotherapy than the stage at diagnosis.

Conclusion: Biomarker research is not just improving, but bringing a transformative change to CRC clinical management. Early detection is not just getting better, but improving thanks to a multi-modality approach, and personalized treatment plans are not just becoming a reality, but a promising future with MRD testing.

用于结直肠癌管理的粪便和血液生物标记物:筛查和疾病监测的最新进展。
背景:生物标记物彻底改变了结直肠癌(CRC)的治疗,促进了早期检测、预防、个性化治疗和最小残留病(MRD)监测。这篇综述探讨了当前的 CRC 筛查策略和新兴的生物标记物应用:我们总结了无创 CRC 筛查和 MRD 检测策略的概况,讨论了当前方法的局限性,并强调了新型生物标记物解决方案的巨大潜力。粪便免疫化学检验仍是 CRC 筛查的基石,但其灵敏度已通过将粪便免疫化学检验的性能与其他粪便分析物相结合而得到提高。然而,它们对晚期腺瘤的灵敏度和患者的依从性仍不理想。基于血液的检测有望提高依从性,但需要进一步改进才能与基于粪便的生物标记物检测相抗衡。理想的情况是,利用血液检测提高筛查参与率,同时在符合筛查要求的患者中推广粪便和内镜筛查。II期和III期结肠癌的治疗曾一度完全依赖于前期手术,然后根据分期和病理情况进行辅助化疗,但随着术后MRD检测的出现,这种治疗方法发生了革命性的转变。十年前,用术后检测代替分期和病理来决定是否需要辅助化疗的概念是颠覆性的。如今,血液检测可能比诊断时的分期更能说明化疗的必要性:生物标志物研究不仅在不断进步,而且为 CRC 临床管理带来了变革。得益于多模式方法,早期检测不仅在不断完善,而且在不断改进,而个性化治疗方案不仅正在成为现实,而且通过 MRD 检测前景广阔。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Molecular Cancer
Molecular Cancer 医学-生化与分子生物学
CiteScore
54.90
自引率
2.70%
发文量
224
审稿时长
2 months
期刊介绍: Molecular Cancer is a platform that encourages the exchange of ideas and discoveries in the field of cancer research, particularly focusing on the molecular aspects. Our goal is to facilitate discussions and provide insights into various areas of cancer and related biomedical science. We welcome articles from basic, translational, and clinical research that contribute to the advancement of understanding, prevention, diagnosis, and treatment of cancer. The scope of topics covered in Molecular Cancer is diverse and inclusive. These include, but are not limited to, cell and tumor biology, angiogenesis, utilizing animal models, understanding metastasis, exploring cancer antigens and the immune response, investigating cellular signaling and molecular biology, examining epidemiology, genetic and molecular profiling of cancer, identifying molecular targets, studying cancer stem cells, exploring DNA damage and repair mechanisms, analyzing cell cycle regulation, investigating apoptosis, exploring molecular virology, and evaluating vaccine and antibody-based cancer therapies. Molecular Cancer serves as an important platform for sharing exciting discoveries in cancer-related research. It offers an unparalleled opportunity to communicate information to both specialists and the general public. The online presence of Molecular Cancer enables immediate publication of accepted articles and facilitates the presentation of large datasets and supplementary information. This ensures that new research is efficiently and rapidly disseminated to the scientific community.
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