The emergence of targetable pathways in colorectal cancer

Colorectal cancer continues to be one of the leading causes of cancer-related morbidity and mortality globally. Despite an overall decreasing incidence of the disease, early-onset colorec­tal cancer is a growing concern. Fluoropyrimidine-based doublet chemotherapy has remained the backbone of treatment in the metastatic setting during the past 2 decades. The increasing acces­sibility and decreasing cost of molecular profiling have made it possible to acquire further insight into prognostic and predictive biomarkers that ultimately help physicians to provide precision medicine in the clinic. In this review, we describe a contemporary biomarker-driven approach to first-line and subsequent-line therapies and highlight the important molecular alterations that affect the treatment of advanced colorectal cancer, along with the supporting clinical trial data.