<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0031_s_004_w2aab3b7c58b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Colorectal cancer (CRC) is one of the most common types of cancer in the world. Metastatic disease is still incurable in most of these patients, but the survival rate has improved by treatment with novel systemic chemotherapy and targeted therapy in combination with surgery. New knowledge of its complex heterogeneity in terms of genetics, epigenetics, transcriptomics and microenvironment, including prognostic and clinical characteristics, led to its classification into various molecular subtypes of metastatic CRC, called consensus molecular subtypes (CMS). The CMS classification thus enables the medical oncologists to adjust the treatment from case to case. They can determine which type of systemic chemotherapy or targeted therapy is best suited to a specific patient, what dosages are needed and in what order.</p></sec><sec id="j_raon-2020-0031_s_005_w2aab3b7c58b1b6b1aab1c16b2Aa"><h3>Conclusions</h3><p>CMS in metastatic CRC are the new tool to include the knowledge of molecular factors, tumour stroma and signalling pathways for personalized, patient-orientated systemic treatment in precision medicine.</p></sec></abstract>

BackgroundColorectal cancer (CRC) is one of the most common types of cancer in the world. Metastatic disease is still incurable in most of these patients, but the survival rate has improved by treatment with novel systemic chemotherapy and targeted therapy in combination with surgery. New knowledge of its complex heterogeneity in terms of genetics, epigenetics, transcriptomics and microenvironment, including prognostic and clinical characteristics, led to its classification into various molecular subtypes of metastatic CRC, called consensus molecular subtypes (CMS). The CMS classification thus enables the medical oncologists to adjust the treatment from case to case. They can determine which type of systemic chemotherapy or targeted therapy is best suited to a specific patient, what dosages are needed and in what order.ConclusionsCMS in metastatic CRC are the new tool to include the knowledge of molecular factors, tumour stroma and signalling pathways for personalized, patient-orientated systemic treatment in precision medicine.

Consensus molecular subtypes (CMS) in metastatic colorectal cancer - personalized medicine decision

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundColorectal cancer (CRC) is one of the most common types of cancer in the world. Metastatic disease is still incurable in most of these patients, but...

CMS subtype	CMS1 -MSI immune	CMS2 - Canonical	CMS3 – Metabolic	CMS4 - Mesenchymal
Frequency	14%	37%	13%	23%
	MSI, CIMP high, hypermutation	SCNA high	Mixed MSI CIMP status, low SCNA low,	SCNA high
	BRAF mutation		KRAS mutation
Characteristics	Immune infiltration and activation	WNT and MYC activation	Metabolic deregulation	Stromal infiltration, TGF-β activation, angiogenesis
	Worse survival after relapse			Worse relapse- free and overall survival

Consensus molecular subtypes (CMS) in metastatic colorectal cancer - personalized medicine decision

Article Category: Review

Published Online: May 28, 2020

Page range: 272 - 277

Received: Mar 13, 2020

Accepted: Apr 29, 2020

DOI: https://doi.org/10.2478/raon-2020-0031

© 2020 Martina Rebersek, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Classification of consensus molecular subtypes (CMS). Adopted by Guiney et al.7