March is Colorectal Cancer Awareness Month and at Frontiers in Oncology we want to highlight the recent discoveries in the field and raise awareness of the importance of early diagnosis, multidisciplinary management, and technological innovation support. Colorectal cancer (CRC) is the third most common cancer worldwide and represents one of the most relevant challenges for present and future global health, with 50 % of patients affected by CRC developing metastasis. Despite the introduction of novel therapeutic approaches and anticancer drugs, colorectal metastatic cancer (mCRC) continue to have a poor prognosis. In the last years, the extensive investigation on biomarkers that could identify patients at high risk for metastasis and predict the response to therapies has deeply impacted the therapeutic approaches to patients with mCRC. The most established biomarkers for mCRC are microsatellite instability (MSI) or mismatch repair deficiency (dMMR), HER2 amplification, RAS/BRAF mutations, and sidedness. Immune checkpoint inhibitors (ICIs) have been extensively used to treat patients with microsatellite unstable or mismatch repair-deficient (dMMR) CRC, while patients harboring a BRAFV600E mutation benefit from combination therapy with chemotherapy and immunotherapy drugs. The success of biomarker-driven patient selection to improve the therapeutic response and the overall survival of patients with mCRC highlights the imperative need for further research to identify novel biomarkers for better patient-tailored therapy.Another important player of mCRC disease management is surgical intervention. The improvement of surgical techniques and of multimodal treatment have deeply affected both the short- and long- outcome of mCRC following surgical resection. Unfortunately, surgical intervention integrated with chemotherapy is a valuable therapeutic option available only for a small proportion of mCRC patients with radiographically resectable disease. Liver surgery associated with induction chemotherapy may give the chance of improving 5-year survival rates in mCRC patients. However, liver resection is complex and characterized by a high rate of recurrence after surgery, suggesting the need of prediction of patient recurrence risk and defining personalized follow-up and treatment strategies. As the mCRC diagnosis and management is complex and multidisciplinary, this Research Topic aims to summarize the progress in the clinical application of biomarkers associated with mCRC and related personalized therapy, as well as the newest improvement in the surgical management of patients with mCRC.We welcome manuscripts addressing but not limited to the following themes: - New surgical approaches to mCRC patients management- Use of Artificial intelligence to choose surgical treatments and clinical applications for mCRC- novel biomarkers for diagnosis, treatment, and prognosis of patients with mCRCPlease note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
March is Colorectal Cancer Awareness Month and at Frontiers in Oncology we want to highlight the recent discoveries in the field and raise awareness of the importance of early diagnosis, multidisciplinary management, and technological innovation support. Colorectal cancer (CRC) is the third most common cancer worldwide and represents one of the most relevant challenges for present and future global health, with 50 % of patients affected by CRC developing metastasis. Despite the introduction of novel therapeutic approaches and anticancer drugs, colorectal metastatic cancer (mCRC) continue to have a poor prognosis. In the last years, the extensive investigation on biomarkers that could identify patients at high risk for metastasis and predict the response to therapies has deeply impacted the therapeutic approaches to patients with mCRC. The most established biomarkers for mCRC are microsatellite instability (MSI) or mismatch repair deficiency (dMMR), HER2 amplification, RAS/BRAF mutations, and sidedness. Immune checkpoint inhibitors (ICIs) have been extensively used to treat patients with microsatellite unstable or mismatch repair-deficient (dMMR) CRC, while patients harboring a BRAFV600E mutation benefit from combination therapy with chemotherapy and immunotherapy drugs. The success of biomarker-driven patient selection to improve the therapeutic response and the overall survival of patients with mCRC highlights the imperative need for further research to identify novel biomarkers for better patient-tailored therapy.Another important player of mCRC disease management is surgical intervention. The improvement of surgical techniques and of multimodal treatment have deeply affected both the short- and long- outcome of mCRC following surgical resection. Unfortunately, surgical intervention integrated with chemotherapy is a valuable therapeutic option available only for a small proportion of mCRC patients with radiographically resectable disease. Liver surgery associated with induction chemotherapy may give the chance of improving 5-year survival rates in mCRC patients. However, liver resection is complex and characterized by a high rate of recurrence after surgery, suggesting the need of prediction of patient recurrence risk and defining personalized follow-up and treatment strategies. As the mCRC diagnosis and management is complex and multidisciplinary, this Research Topic aims to summarize the progress in the clinical application of biomarkers associated with mCRC and related personalized therapy, as well as the newest improvement in the surgical management of patients with mCRC.We welcome manuscripts addressing but not limited to the following themes: - New surgical approaches to mCRC patients management- Use of Artificial intelligence to choose surgical treatments and clinical applications for mCRC- novel biomarkers for diagnosis, treatment, and prognosis of patients with mCRCPlease note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.