XXXX : Personalized Therapy.

@entity1 @entity7 @entity5 @entity470 @entity984 @entity3 @entity14 @entity8497 @entity2513 @entity694
BACKGROUND: @entity14 ( @entity14 ) is the second most common type of @entity5 in the Western world. The treatment of this disease has evolved greatly, particularly for @entity1 with @entity3 . The advent of combination chemotherapy plus targeted agents has led to more curative resections and improved survival rates in these @entity1 . A deeper understanding of the mechanisms of tumorigenesis has facilitated @entity5 characterization, prognosis and @entity1 stratification, bringing us one step closer towards personalized medicine. SUMMARY: There are two main pathways of @entity14 development: (1) chromosomal instability, also known as the classical @entity2513 sequence, and (2) microsatellite instability, caused by a defective mismatch repair (dMMR) system. Analysis of these pathways has uncovered key prognostic and predictive biomarkers to guide @entity1 selection and treatment strategy. This review summarizes the current treatment regimens and recent advances in the personalized therapy of @entity14 . KEY MESSAGE: Understanding of the mechanisms of @entity14 pathogenesis has led to new developments in @entity5 characterization, @entity1 stratification, prognosis and treatment, bringing us closer to personalized therapy. PRACTICAL IMPLICATIONS: In the adjuvant setting, the treatment decision is driven by clinical and histopathological factors. dMMR status is one of the most robust positive prognostic factors in resected @entity694 . More and more guidelines recommend refraining from adjuvant chemotherapy in @entity1 with dMMR. In the metastatic setting, the introduction of effective compounds, including agents that target the @entity470 and @entity7 pathways, has significantly improved survival. The presence of wild-type @entity984 and @entity8497 (all RAS) is a positive predictive factor for @entity470 antibody treatment. Therefore, analysis of all RAS status is recommended for all @entity1 with @entity3 prior to the initiation of first-line chemotherapy.
