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  • Genetic regressive trajecto...
    Ottaiano, Alessandro; Santorsola, Mariachiara; Caraglia, Michele; Circelli, Luisa; Gigantino, Valerio; Botti, Gerardo; Nasti, Guglielmo

    Translational oncology, 08/2021, Letnik: 14, Številka: 8
    Journal Article

    •Progression of colorectal cancer relies on the accumulation of gene mutations.•About 10% of metastatic patients present with an oligo-metastatic disease.•Next generation sequencing are clarifying the genetics of oligo-metastases.•“Regressive” genetic trajectories are found in oligo-metastatic progression. Colorectal cancer (CRC) originates as consequence of multiple genetic alterations. Some of the involved genes have been extensively studied (APC, TP53, KRAS, SMAD4, PIK3CA, MMR genes) in highly heterogeneous and poly-metastatic cohorts. However, about 10% of metastatic CRC patients presents with an indolent oligo-metastatic disease differently from other patients with poly-metastatic and aggressive clinical course. Which are the genetic dynamics underlying the differences between oligo- and poly-metastatic CRC? The understanding of the genetic trajectories (primary→metastatic) of CRC, in patients selected to represent homogenous clinical models, is crucial to make genotype/phenotype correlations and to identify the molecular events pushing the disease towards an increasing malignant phenotype. This information is crucial to plan innovative therapeutic strategies aimed to reverse or inhibit these phenomena. In the present study, we review the genetic evolution of CRC with the intent to give a developmental perspective on the border line between oligo- and poly-metastatic diseases. Display omitted