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Cancer types

Colorectal Cancer

Colorectal cancer covers cancers of the colon and rectum, with RAS, BRAF, MSI/MMR, and HER2 status shaping systemic treatment options.

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Ilustrasi editorial usus besar dengan satu area tumor pada dinding kolon
KRASBRAFMSI / MMRHER2NTRK

Not a diagnosis and not final medical advice. Must be reviewed by a doctor.

What is most important to know?

Most colorectal cancers originate from adenocarcinoma which develops from polyps in the intestinal wall.

Molecular status is particularly important: RAS and BRAF status influence whether the anti-EGFR antibody category is relevant, while MSI/MMR status opens up the immunotherapy category in some patients.

Liver or lung involvement in advanced stages is often part of the discussion, including the possibility of local treatment for limited lesions.

Colorectal cancer is one of the most frequently diagnosed cancers in the world, and the number of cases at a younger age is reported to be increasing in several countries. Specific figures are not shown without direct quotation.

Tumour location and biomarkers both matter.

Commonly discussed symptoms

  • Persistent changes in bowel patterns.
  • Blood in the stool or black stool.
  • Stomach pain or cramps.
  • Weight loss and fatigue due to anemia.
  • Feeling of incompleteness after defecation.

These symptoms are not specific. A doctor still needs to assess the cause.

Risk factors

  • Older age.
  • Previous history of adenoma polyps or colorectal cancer.
  • Family history and certain genetic conditions such as Lynch syndrome.
  • Lifestyle factors include diet and physical activity levels.

What shapes the options?

Treatment discussions usually follow this path. The more complete each step is, the more focused the discussion with your doctor becomes.

  1. Diagnosis

    Confirmed through pathology review.

  2. Subtype

    3 subtypes discussed on this page.

  3. Stage

    Staging uses the TNM system which assesses the depth of intestinal wall invasion, lymph node involvement, and distant spread.

  4. Biomarkers

    Relevant markers: KRAS, BRAF, MSI / MMR, HER2, NTRK.

  5. Treatment history

    Each previous line affects the next option.

  6. Progression?

    If the disease progresses, reassessment and molecular testing are usually discussed.

  7. Next step

    Further evaluation, clinical trials, or a second opinion.

Stage I

Tumour limited to the bowel lining without spread to lymph nodes.

Stage II

Tumour has penetrated the bowel wall without lymph node involvement.

Stage III

Lymph nodes around the bowel are involved.

Stage IV

There is spread to another organ such as the liver or lung.

Relevant biomarkers

Molecular testing shapes categories, not decisions

Biomarker results open categories worth discussing. The final choice still considers stage, general condition, treatment history and the doctor's assessment.
Ilustrasi reseptor di permukaan sel dengan molekul ligan yang mendekat

  • KRAS

    KRAS is a gene that regulates growth signals.

    Next-generation sequencing (NGS) · KRAS PCR

    View biomarker →

  • BRAF

    BRAF is a gene that regulates cell growth signals.

    Next-generation sequencing (NGS) · BRAF PCR

    View biomarker →

  • MSI / MMR

    Cells have a DNA repair system.

    MMR immunohistochemistry · MSI PCR

    View biomarker →

  • HER2

    HER2 is a protein on the surface of cells that can promote growth.

    Immunohistochemistry (IHC) · FISH (fluorescence in situ hybridisation)

    View biomarker →

  • NTRK

    NTRK fusion is a change that combines the NTRK gene with another gene.

    Next-generation sequencing (NGS) · Immunohistochemistry (IHC)

    View biomarker →

Progression and resistance concepts

  • Progression can occur locally, regionally, or through spread to the liver, lungs, and stomach lining.
  • Molecular status may change after therapy, so reexamination of new tissue is sometimes considered.
  • In diseases with lesions limited to the liver, discussions often include the possibility of surgery or local treatment of the lesions.
  • Subsequent choices consider regimen history, tolerance to previous therapy, and availability of clinical trials.

Treatment options commonly discussed

The actual order and combination are always determined by the team directly examining the patient.

When are clinical trials discussed?

Trial group and treatment history

The studies below are filtered from the public registry. International patient access and site readiness have not been verified.

Clinical trials are usually discussed after standard pathways are mapped, or when biomarker results point to a specifically studied group. There are currently 0 registry records related to Colorectal cancer, and 0 mention a specific biomarker.

NO DATA

No studies were filtered for this cancer group in the latest registry data.

View all 0 studiesCheck my case match

What should be prepared for a second opinion?

Records usually requested

  • Latest colonoscopy and pathology reports.
  • RAS, BRAF, MSI/MMR, and HER2 examination results.
  • Recent CT scan of the chest, abdomen, and pelvis.
  • Records of previous operations along with pathology reports.
  • Note the chemotherapy regimen that has been undertaken and the response.

Questions for the oncologist

  • Have my RAS, BRAF, MSI/MMR and HER2 status been completely checked?
  • How does this molecular status change my therapeutic options?
  • Can lesions in the liver or lungs still be treated with local measures?
  • Do I need genetic testing to assess family risk?
  • Are there any clinical trials that match my markers?

Have KRAS and BRAF been tested in your case?

Not sure about the next step for Colorectal cancer?

Build a case summary so your documents and questions are organised before choosing the next step. This is what happens after you upload.

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  3. Navigator review

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  4. Provider review

    With your consent, the case is discussed with providers for assessment and a written quote.

Not sure about the next step for Colorectal cancer?

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Deeper references

A reference section for readers who want details on subtypes, drugs, or every study record.

Colon adenocarcinoma

Draft, not yet medically reviewed

The most common form in the colon, developing from the inner lining of the bowel wall.

RAS and BRAF status determine whether anti-EGFR antibodies are relevant. MSI/MMR status determines whether immunotherapy is considered.

Stage note

The depth of invasion and lymph node involvement determine the stage and need for additional therapy.

Colorectal cancer with DNA repair deficiency (dMMR or MSI-high)

Draft, not yet medically reviewed

A group with DNA repair deficiency that opens an immunotherapy category and requires consideration of genetic risk.

Tumors with dMMR have many genetic changes so they are easier for the immune system to recognize. This condition may also be associated with Lynch syndrome affecting familial risk.

Relevant markers

MSI / MMR

Stage note

Staging still uses the TNM system, but dMMR status adds its own consideration in the choice of systemic therapy.

Rectal adenocarcinoma

Draft, not yet medically reviewed

Cancer in the final part of the large bowel, with special considerations around pelvic function and treatment sequence.

The location of the tumor in the pelvis means that treatment planning takes into account surrounding organs such as the sphincter and bladder, and radiotherapy is often used before surgery.

Relevant markers

KRASBRAFMSI / MMRHER2

Stage note

Pelvic MRI is an important part of assessing how close the tumor is to surrounding tissue and determining the order of therapy.

Next steps

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What you can do

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    Review of the treatment plan

    Reason: Relevant when a treatment plan is being considered

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    A request is recorded with this page context

    Reason: For asking the next step directly

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