Molecular profiling changes the management of Colorectal Cancer significantly. This blog lists all relevant molecular markers associated with prognostic, response to chemotherapy, survival and recurrence of Colon Cancer.
The markers are chosen based on the basis of gene expression profile on colon cancer. As the cancer advances, it accumulates several genetic aberrations. Spread of cancer, response to treatment, survival to treatment and recurrence are all associated with different molecular markers.
These markers have been shortlisted from existing literature, experience with patients and the outcome. However, this is based upon my understanding and experience with patients and any decision based upon this blog need to be approved by your treating physician. I take no responsibility for decisions and or outcome based on these markers.
Many Molecular markers have been used for prediction and prognosis. Key amongst those are –
- MSI – Microsatellite Instability with the mismatch repair MMR system, MSI-H, MSI , MLH1, MsH2, MsH3, MsH6 and PMs2
- EGFR –
- VEGF
- KRAS mutation in Codon 12, 13, 61
- PTEN mutation
- PIK3CA Mutation
- BRAF V600E (Exon 15)
- p53
CEA – Carcinoembryonic antigen – CEA is separated from other molecular markers since CEA helps in understanding tumor burden and is also required for regular follow up.
Tissue Sampling:
The tissues should be immediately placed into liquid nitrogen upon excision and meticulously selected pathologist for molecular profiling. Samples both from primary and secondaries (Lymph nodes) are required. Remember, to submit normal tissue along with the disease sample.
Dry Ice can be used as a media only for selected tests.
This page is under construction. I will update the markers as well as the references.
For Understanding the different surgical and chemotherapy options, you may visit –
mymilieu.org 