Evolving Perspectives in Colon Cancer Treatment and Research

Dear Colleagues,

Precision medicine is increasingly developing therapy algorithms through the identification and characterization of markers according to their involvement in distinct cancer pathways.

Regarding the early stage of the disease, one major question concerns the risk of recurrence and minimal residual disease: when is staging based on pathologic features adequate for shared therapeutic evaluation? Could circulating tumor DNA (ctDNA) prove useful in relapse-risk stratification? These are the main issues concerning future developments.

A revolution in colon cancer therapy has been brewing. The efficacy of PD-1 blockade for MSI-H-dMMR advanced colon cancer has been established and is the new standard of care for MSI-H tumors. Moreover, new data are emerging on the combination of immune checkpoint inhibitors (PD-1, CTLA4) in MSS tumors in different settings.

While the amount of biomarker testing in colon cancer has significantly increased over time, we have also been witness to an evolution from negative selection options (i.e., the presence of RAS mutation and the use of anti-EGFR inhibitors) to positive ones. There has been unprecedented achievement in patients with BRAFV600E mutant colon cancer when disease had previously progressed after prior regimens. Encouraging results have also been obtained in RAS mutant tumors with activating KRAS codon 12 mutations or in heavily pretreated HER-2-expressing colon cancers. As numerous biomarkers are being studied according to a histology-agnostic approach, the number of potentially actionable ones could increase.

This Special Issue aims to provide an overview of the main achievements in the field of colon cancer treatment, providing prospective lines of research. We also would like to provide comprehensive overviews over important aspects of the molecular events in the Colon cancer life cycle, disease development and the current state of Colon cancer treatment.

Dr. Francesca Virginia Negri
Guest Editor

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