Can histone epigenetic profiling become an alternative treatment modality for colon cancer

Colorectal cancer (CRC) is a formidable health problem worldwide. Almost 60% of cases are encountered in developed countries. In India, the annual incidence rates (AARs) for colon cancer in men are 4.4 per 100000. The AAR for colon cancer in women is 3.9per 100000 (GLOBO. CAN 2008). There were marked developments in the chemotherapy of CRC in the last decade. Eight new drugs were approved for chemotherapy. The survival has doubled compared to 5-fluorouracil alone. KRAS testing opened an era of personalised therapy. Though on an average there are 90 genes mutated per cancer, only less than 20 pathways will actually drive cancer development. The available therapy with combinations for CRC is very expensive coming to $300000 for 24 months. Early detection of tumors and improved therapy has lead to improvement in survival. With the administration of the adjuvant 5-fluorouracil, an improvement in survival of approximately 30%, with an additional 20% improvement with the addition of oxaliplatin in stage III colon cancer is reported. Family history of CRC contributes only 25% thus most commonly occurs sporadically, suggesting a contribution for shared genes and environment. About 5-% are from inherited mutations, while the remaining of the familial forms results from gene environment interactions.