Predicting the response to targeted therapy in metastatic colorectal cancer

Colorectal cancer is the second most common cause of cancer-related deaths in Australia. The median survival of metastatic colorectal cancer remains poor, but novel targeted therapies offer promise in improving patient outcomes. However, it is vital to identify which patients with metastatic colorectal cancer will benefit from targeted therapy. Predictive biomarkers offer significant benefit by refining the treatment population to a subgroup that has a greater prospect of benefit from therapy. This provides efficacy benefits, but also minimizes the overall toxicity and cost of treatment. In this review we examine current knowledge regarding predictive biomarkers for targeted agents in metastatic colorectal cancer, with a particular focus on emerging biomarkers such as oncogenic mutations. We also highlight issues that require further exploration in the quest for personalized therapy in metastatic colorectal cancer.