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World J Gastroenterol. Nov 28, 2007; 13(44): 5888-5901
Published online Nov 28, 2007. doi: 10.3748/wjg.v13.i44.5888
Pharmacogenomics in colorectal cancer: The first step for individualized-therapy
Eva Bandrés, Ruth Zárate, Natalia Ramirez, Ana Abajo, Nerea Bitarte, Jesus García-Foncillas
Eva Bandrés, Ruth Zárate, Natalia Ramirez, Ana Abajo, Nerea Bitarte, Jesus García-Foncillas, Laboratory of Pharma-cogenomics, Cancer Research Program (Center for Applied Medical Research), University of Navarra, Navarra, Spain
Author contributions: All authors contributed equally to the work.
Correspondence to: Eva Bandrés Elizalde, PhD, Laboratory of Pharmacogenomics, Center for Applied Medical Research, University of Navarra, Avda Pio XII 55, Pamplona 31008, Spain. ebandres@unav.es
Telephone: +34-948-194700 Fax: +34-948-194714
Received: November 2, 2006
Revised: November 24, 2006
Accepted: September 19, 2007
Published online: November 28, 2007
Abstract

Interindividual differences in the toxicity and response to anticancer therapies are currently observed in practically all available treatment regimens. A goal of cancer therapy is to predict patient response and toxicity to drugs in order to facilitate the individualization of patient treatment. Identification of subgroups of patients that differ in their prognosis and response to treatment could help to identify the best available drug therapy according the genetic profile. Several mechanisms have been suggested to contribute to chemo-therapeutic drug resistance: amplification or overexpression of membrane transporters, changes in cellular proteins involved in detoxification or in DNA repair, apoptosis and activation of oncogenes or tumor suppressor genes. Colorectal cancer (CRC) is regarded as intrinsically resistant to chemotherapy. Several molecular markers predictive of CRC therapy have been included during the last decade but their results in different studies complicate their application in practical clinical. The simultaneous testing of multiple markers predictive of response could help to identify more accurately the true role of these polymorphisms in CRC therapy. This review analyzes the role of genetic variants in genes involved in the action mechanisms of the drugs used at present in colorectal cancer.

Keywords: Colorectal cancer; Pharmacogenomics; Che-motherapy; Polymorphisms; Markers