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Recent Advances and Challenges in Colorectal Cancer: From Molecular Research to Treatment

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Oncology".

Deadline for manuscript submissions: 20 September 2025 | Viewed by 1376

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Guest Editor
Division of Surgical Oncology, Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
Interests: global cancer research; colorectal cancer; pancreatic cancer; cancer biology; cancer metastasis; cancer biomarkers; molecular biology; cell survival; apoptosis; signaling pathways; medical education
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Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide. In the majority of cases, CRC begins as a benign adenomatous polyp, transitions into an advanced adenoma, and progresses to an invasive cancer. The best-studied molecular pathways involved in CRC can be broadly classified, based on their genetic mutation status, as oncogenic and tumor suppressor pathways. However, CRC is heterogeneous, and challenges exist in understanding the full spectrum of mechanisms that initiate its development and drive progression and metastasis, as well as in determining their responsiveness to anticancer therapeutic strategies.

Over the last decade, there have been major advances in the molecular profiling of CRC, significantly improving our understanding of CRC tumor heterogeneity and providing results for diagnostic classification and targeted treatment strategies. As a result, CRC treatment, particularly metastatic CRC, has evolved significantly, reflected by the use of many chemotherapeutic combinations and the integration of novel targeted therapies into clinical practice. However, the efficacy of these agents is often limited due to the rapid evolution of drug resistance and cancer recurrence.

Tumor heterogeneity is one of the main mechanisms of drug resistance in CRC, mainly due to genetic and epigenetic mechanisms. Therefore, understanding CRC’s molecular complexity is required to facilitate the development of novel therapeutic strategies to reduce drug resistance and enhance patient survival.

Dr. Premila Leiphrakpam
Guest Editor

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Keywords

  • tumor biology
  • tumor heterogeneity
  • molecular mechanism involved in cancer initiation, progression, and metastasis
  • compensatory pathways
  • cancer screening
  • cancer biomarkers discovery
  • tumor molecular profiling methods
  • early cancer diagnosis
  • novel therapeutic strategies
  • targeted therapies
  • drug resistance

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Published Papers (1 paper)

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Review

16 pages, 2514 KiB  
Review
Circulating Tumor DNA as a Real-Time Biomarker for Minimal Residual Disease and Recurrence Prediction in Stage II Colorectal Cancer: A Systematic Review and Meta-Analysis
by Silvia Negro, Alessandra Pulvirenti, Chiara Trento, Stefano Indraccolo, Stefania Ferrari, Marco Scarpa, Emanuele Damiano Luca Urso, Francesca Bergamo, Salvatore Pucciarelli, Simona Deidda, Angelo Restivo, Sara Lonardi and Gaya Spolverato
Int. J. Mol. Sci. 2025, 26(6), 2486; https://doi.org/10.3390/ijms26062486 - 11 Mar 2025
Viewed by 975
Abstract
The role of adjuvant chemotherapy (adj-CT) in stage II colon cancer remains controversial. Circulating tumor DNA (ctDNA) is a promising biomarker for detecting minimal residual disease (MRD) and predicting recurrence. This systematic review and meta-analysis evaluated the prognostic value of ctDNA in stage [...] Read more.
The role of adjuvant chemotherapy (adj-CT) in stage II colon cancer remains controversial. Circulating tumor DNA (ctDNA) is a promising biomarker for detecting minimal residual disease (MRD) and predicting recurrence. This systematic review and meta-analysis evaluated the prognostic value of ctDNA in stage II colorectal cancer (CRC), focusing on postoperative detection, post adj-CT outcomes, and dynamic surveillance. A literature search identified studies correlating ctDNA positivity in stage II CRC with recurrence risk, recurrence-free survival (RFS), and disease-free survival (DFS). Seven studies met the inclusion criteria. Postoperative ctDNA positivity significantly increased the risk of recurrence (pooled risk ratio [RR:] 3.66; 95% confidence interval [CI]: 1.25–10.72; p = 0.002). CtDNA positivity after adj-CT was strongly associated with poor survival, while dynamic ctDNA monitoring detected recurrence earlier than conventional methods, including carcinoembryonic antigen (CEA) and imaging. CtDNA is a robust prognostic biomarker in stage II CRC, enabling personalized treatment. High-risk ctDNA-positive patients may benefit from intensified therapy, while ctDNA-negative patients could avoid unnecessary treatments. However, the standardization of detection methods and large-scale validation studies are needed before integrating ctDNA into routine clinical practice as a non-invasive, dynamic tool for personalized care. Full article
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