Cancer Genetics and Epigenetics 2024, Vol.12, No.6, 317-328 http://medscipublisher.com/index.php/cge 323 5.3 Case study: management of therapy-resistant CRC A recent case study highlighted the successful management of a therapy-resistant CRC patient through the application of combination therapy based on genetic profiling. The patient, who had developed resistance to standard anti-EGFR therapy due to secondary KRAS mutations, was treated with a combination of MEK and PI3K inhibitors. This regimen led to significant tumor regression and prolonged progression-free survival, demonstrating the potential of personalized medicine in overcoming resistance (Tsubaki et al., 2019). 6 Future Prospects in CRC Diagnosis and Treatment The future of colorectal cancer (CRC) diagnosis and treatment is poised to be shaped by rapid advancements in genetic research and the integration of novel technologies. These developments promise to enhance early detection, personalize treatment strategies, and ultimately improve patient outcomes. 6.1 Advances in genetic research and technology Recent advancements in genetic research, particularly through Next-Generation Sequencing (NGS) and other high-throughput technologies, have significantly expanded our understanding of the molecular underpinnings of CRC. These technologies allow for the comprehensive analysis of genetic mutations, epigenetic changes, and tumor microenvironment interactions. This progress is expected to lead to the discovery of new therapeutic targets and more refined diagnostic tools that are tailored to individual patient profiles (Kyrochristos et al., 2019; Verbanac et al., 2021). 6.2 Potential for novel diagnostic markers The identification of novel diagnostic markers is one of the most promising areas in CRC research. These markers, which may include specific genetic mutations, circulating tumor DNA (ctDNA), and epigenetic signatures, could significantly enhance the accuracy and timing of CRC diagnosis. By enabling earlier detection, these markers could improve the effectiveness of treatments and reduce mortality rates (Ogunwobi et al., 2020; Al-Joufi et al., 2022). 6.3 Prospects of personalized medicine in CRC Personalized medicine is expected to play a central role in the future management of CRC. By tailoring treatment plans based on the unique genetic and molecular profile of each patient’s tumor, personalized medicine aims to optimize therapeutic efficacy while minimizing adverse effects. This approach is already showing promise in improving outcomes for CRC patients and is likely to become the standard of care as more targeted therapies are developed (Singh et al., 2019; Di Nicolantonio et al., 2021). 6.4 Integration of genetic profiles with other diagnostic tools The integration of genetic profiling with other diagnostic modalities, such as imaging and liquid biopsies, represents a significant advancement in the management of CRC. Combining these approaches allows for a more comprehensive assessment of the tumor and its behavior, leading to more accurate diagnoses and better-informed treatment decisions. This multidisciplinary approach is expected to improve the precision of CRC management, offering a holistic view of the disease and its progression (Durinikova et al., 2021; Wu et al., 2022). 7 Ethical and Practical Considerations The implementation of genetic testing in colorectal cancer (CRC) care brings significant ethical and practical considerations that must be addressed to ensure that these advancements are applied responsibly and equitably. 7.1 Ethical implications of genetic testing Genetic testing for CRC can reveal information not only about the patient but also about their family members, raising ethical concerns about privacy, consent, and the potential psychological impact of test results. The identification of hereditary cancer syndromes, such as Lynch syndrome, may lead to decisions regarding prophylactic surgeries or intensified surveillance, which can have profound implications for patients and their families (Lorans et al., 2018). Additionally, the potential for discrimination based on genetic information, despite legal protections, remains a concern, especially in the realms of insurance and employment (Kastrinos et al., 2019).
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