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Current Status, Challenges and Future of Precision Medicine for Colorectal...
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Current Status, Challenges and Future of Precision Medicine for Colorectal Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (1 October 2024) | Viewed by 2890

Special Issue Editors

Prof. Dr. Brian Davidson

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Guest Editor
Division of Surgery & Interventional Sciences, University College London, London, UK
Interests: pathogenesis of HPB cancers; surgical innovation; organ preservation; machine perfusion; US histotripsy; irreversible electroporation (IRE); evidence based healthcare
Prof. Dr. Jamie Murphy

E-Mail Website
Guest Editor
Department of Surgery and Cancer, Imperial College London, London, UK
Interests: innovations in management of stage 4 colorectal cancer; locally advanced colorectal cancer; recurrent rectal cancer; peritoneal cancer; anal cancer
Dr. Khurum Khan

E-Mail Website
Guest Editor
Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU, UK
Interests: colorectal cancer; anal cancer; bile duct cancer (cholangiocarcinoma); biliary cancer; cancer of unknown primary; colon cancer; gastrointestinal cancers; medical oncology; small bowel cancer liquid biopsies; tumour heterogeneity; patient-derived organoids; bioinformatics; next generation sequencing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Precision medicine or personalized medicine is a rapidly evolving approach in colorectal cancer treatment in which therapy is tailored to individual patients based on the integration of data onthe disease characteristics on imaging, the histological phenotype of the cancer, the cancer genomic and proteomic profiles, the natural history of the disease progression and the response patterns to treatment. Increasingly this complex integration of information is used to anticipate treatment responses and the optimization of therapy.

This special issue aims to provide a comprehensive overview of the current status, challenges, and future prospects of precision medicine in colorectal cancer. It explores the molecular classification of colorectal cancer and highlights the recent advancements in targeted therapies, immunotherapies, and liquid biopsies. The impact of this molecular information and immunological treatment on surgical management of primary and metastatic disease will be reviewed including controversial areas such as synchronous bowel and liver resection and liver transplant for colorectal cancer.

We will explore the potential of next-generation sequencing, radiomics, artificial intelligence and machine learning to improve the diagnosis, prognosis and monitoring of CRC patients. We hope that this special issue will provide a comprehensive and updated overview of precision medicine for CRC and stimulate further research and innovation in this field. We look forward to receiving your contributions.

Prof. Dr. Brian Davidson
Prof. Dr. Jamie Murphy
Dr. Khurum Khan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • colorectal cancer 
  • precision medicine
  • personalised medicine
  • synchronous resection 
  • downstaging 
  • liver transplant 
  • molecular profiling 
  • biomarkers 
  • radiomics 
  • targeted therapy 
  • immunotherapy 
  • liquid biopsy 
  • next-generation sequencing 
  • machine learning 
  • artificial intelligence

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Published Papers (3 papers)

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Research

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26 pages, 695 KiB  
Article
A Novel Approach for Predicting the Survival of Colorectal Cancer Patients Using Machine Learning Techniques and Advanced Parameter Optimization Methods
by Andrzej Woźniacki, Wojciech Książek and Patrycja Mrowczyk
Cancers 2024, 16(18), 3205; https://doi.org/10.3390/cancers16183205 - 20 Sep 2024
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Abstract
Background: Colorectal cancer is one of the most prevalent forms of cancer and is associated with a high mortality rate. Additionally, an increasing number of adults under 50 are being diagnosed with the disease. This underscores the importance of leveraging modern technologies, such [...] Read more.
Background: Colorectal cancer is one of the most prevalent forms of cancer and is associated with a high mortality rate. Additionally, an increasing number of adults under 50 are being diagnosed with the disease. This underscores the importance of leveraging modern technologies, such as artificial intelligence, for early diagnosis and treatment support. Methods: Eight classifiers were utilized in this research: Random Forest, XGBoost, CatBoost, LightGBM, Gradient Boosting, Extra Trees, the k-nearest neighbor algorithm (KNN), and decision trees. These algorithms were optimized using the frameworks Optuna, RayTune, and HyperOpt. This study was conducted on a public dataset from Brazil, containing information on tens of thousands of patients. Results: The models developed in this study demonstrated high classification accuracy in predicting one-, three-, and five-year survival, as well as overall mortality and cancer-specific mortality. The CatBoost, LightGBM, Gradient Boosting, and Random Forest classifiers delivered the best performance, achieving an accuracy of approximately 80% across all the evaluated tasks. Conclusions: This research enabled the development of effective classification models that can be applied in clinical practice. Full article
(This article belongs to the Special Issue Current Status, Challenges and Future of Precision Medicine for Colorectal Cancer)
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14 pages, 990 KiB  
Article
PD-L1 Expression in Paired Samples of Rectal Cancer
by Mina Coussement, Roberta Fazio, Alessandro Audisio, Reem El Khoury, Fatima-Zahra Abbassi, Irene Assaf, Chiara Conti, Chiara Gallio, Nada Benhima, Giacomo Bregni, Paraskevas Gkolfakis, Valentina Spagnolo, Geraldine Anthoine, Gabriel Liberale, Luigi Moretti, Philippe Martinive, Alain Hendlisz, Pieter Demetter and Francesco Sclafani
Cancers 2024, 16(14), 2606; https://doi.org/10.3390/cancers16142606 - 21 Jul 2024
Viewed by 894
Abstract
Immune checkpoint inhibitors and immune-related biomarkers are increasingly investigated in rectal cancer (RC). We retrospectively analysed PD-L1 expression in diagnostic biopsy and resection samples from RC patients treated at our centre between 2000 and 2020. PD-L1 immunostaining (22C3 clone) was evaluated according to [...] Read more.
Immune checkpoint inhibitors and immune-related biomarkers are increasingly investigated in rectal cancer (RC). We retrospectively analysed PD-L1 expression in diagnostic biopsy and resection samples from RC patients treated at our centre between 2000 and 2020. PD-L1 immunostaining (22C3 clone) was evaluated according to tumour proportion (TPS), immune cell (ICS), and the combined positive score (CPS). Eighty-three patients were included. At diagnosis, PD-L1 expression ≥1%/≥5% was observed in 15.4%/0%, 80.7%/37.4%, and 69.2%/25.6% of patients based on TPS, ICS, and CPS, respectively. At surgery, the respective figures were 4.6%/1.5%, 60.2%/32.5%, and 50.7%/26.2%. Using the 1% cut-off and regardless of the scoring system, PD-L1 was less expressed in surgery than biopsy samples (p ≤ 0.04). In paired specimens, PD-L1-ICS reduction was especially observed following neoadjuvant long-course (chemo)radiotherapy (p = 0.03). PD-L1-ICS of ≥5% in surgical samples (HR: 0.17; p = 0.02), and a biopsy-to-surgery increase in PD-L1-ICS (HR: 0.19; p = 0.04) was predictive for longer disease-free survival, while the PD-L1-ICS of either ≥1% (HR 0.28; p = 0.04) or ≥5% (HR 0.19; p = 0.03) in surgical samples and the biopsy-to-surgery increase in PD-L1-ICS (HR: 0.20; p = 0.04) were associated with better overall survival. Our study suggests that PD-L1 expression in RC is largely reflective of immune cell infiltration, and its presence/increase in surgical samples predicts better outcomes. Full article
(This article belongs to the Special Issue Current Status, Challenges and Future of Precision Medicine for Colorectal Cancer)
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Review

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26 pages, 762 KiB  
Review
Challenges and Opportunities for Precision Surgery for Colorectal Liver Metastases
by Robert Michael O’Connell and Emir Hoti
Cancers 2024, 16(13), 2379; https://doi.org/10.3390/cancers16132379 - 28 Jun 2024
Viewed by 1010
Abstract
The incidence of colorectal cancer and colorectal liver metastases (CRLM) is increasing globally due to an interaction of environmental and genetic factors. A minority of patients with CRLM have surgically resectable disease, but for those who have resection as part of multimodal therapy [...] Read more.
The incidence of colorectal cancer and colorectal liver metastases (CRLM) is increasing globally due to an interaction of environmental and genetic factors. A minority of patients with CRLM have surgically resectable disease, but for those who have resection as part of multimodal therapy for their disease, long-term survival has been shown. Precision surgery—the idea of careful patient selection and targeting of surgical intervention, such that treatments shown to be proven to benefit on a population level are the optimal treatment for each individual patient—is the new paradigm of care. Key to this is the understanding of tumour molecular biology and clinically relevant mutations, such as KRAS, BRAF, and microsatellite instability (MSI), which can predict poorer overall outcomes and a poorer response to systemic therapy. The emergence of immunotherapy and hepatic artery infusion (HAI) pumps show potential to convert previously unresectable disease to resectable disease, in addition to established systemic and locoregional therapies, but the surgeon must be wary of poor-quality livers and the spectre of post-hepatectomy liver failure (PHLF). Volume modulation, a cornerstone of hepatic surgery for a generation, has been given a shot in the arm with the advent of liver venous depletion (LVD) ensuring significantly more hypertrophy of the future liver remnant (FLR). The optimal timing of liver resection for those patients with synchronous disease is yet to be truly established, but evidence would suggest that those patients requiring complex colorectal surgery and major liver resection are best served with a staged approach. In the operating room, parenchyma-preserving minimally invasive surgery (MIS) can dramatically reduce the surgical insult to the patient and lead to better perioperative outcomes, with quicker return to function. Full article
(This article belongs to the Special Issue Current Status, Challenges and Future of Precision Medicine for Colorectal Cancer)
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