Patients with metastatic colorectal cancer have a short life expectancy – currently about 30 months - itself an improvement on previous survival figures. To improve this figure, treatment of colorectal cancer has become personal. Research is revealing the complex intricacies of the primary tumour, and the molecular changes that drive the disease. By ongoing sampling of the patient and analysis of the results, the progress of treatments can be assessed and the evolutionary impact on the tumour of chemotherapeutics can be gauged. Knowledge of current mutations allows the use of drugs that will be most effective, most likely to improve survival – the era of precision medicine and immunotherapy. Despite progress made, the development of molecular markers to stratify patients, the ability to analyse the mutational status of circulating tumour DNA and individualization of treatments, for some patients there is still no convincing standard of care, and new options are a medical need.
The progress made to date in treating colorectal cancer is a testament to ongoing research in collaboration with skilled clinical treatments and feedback - the “virtuous cycle” of bench to bedside to bench in action.