How to stratify colorectal cancer treatment

  The results of the CRYSTAL study were reported at the 15th European Cancer Congress: EGFR inhibitors had a significant clinical benefit on overall survival in patients with metastatic colorectal first-line treatment. The study included 1063 patients with metastatic colorectal cancer with KRAS mutation and response to different treatments. The results showed that the efficiency of chemotherapy combined with cetuximab was 57.3% in the KRAS wild-type patients, higher than 39.7% in the unilateral chemotherapy group, and their median disease-free survival and median overall survival were also higher than those of chemotherapy alone.  Currently, for metastatic colorectal cancer, conventional chemotherapy has a 5-year survival rate of less than 5%. Investigators hope to improve patient survival by achieving population-stratified treatment through molecular tumor typing. Approximately 60-70% of patients with metastatic colorectal cancer are KRAS wild type. This study found that cetuximab was effective in treating KRAS wild-type metastatic colorectal cancer. By finding the KRAS typing of patients through gene mutation monitoring, clinicians will be able to effectively provide individualized treatment plans for patients.  Currently, in addition to KRAS gene, other molecular markers being investigated in the field of colorectal cancer include BRAF and PTEN. As research progresses, in-depth stratification of patients’ treatment sensitivity is expected to make colorectal cancer treatment more individualized and humanized.