The American Society for Clinical Pathology together with the College of American Pathologists, the Association for Molecular Pathology, and the American Society of Clinical Oncology have recently published a guideline for biomarkers in the evaluation of colorectal cancer (CRC).¹ In this article the authors support testing for RAS mutations as a negative predictor of response to EGFR-targeted monoclonal antibodies, whereas BRAF mutations and mismatched repair (MMR) status are recommended for their prognostic value and as heralds of Lynch syndrome. Unexpectedly, human epidermal growth factor receptor 2 (HER2, also referred to as ERBB2) amplification is not considered.¹ In metastatic CRC as in other tumors there is a compelling need to discriminate validated prognostic or predictive biomarkers from others with insufficient evidence. However, the landscape of molecular biomarkers is rapidly evolving, and new paradigms of precision medicine imply therapeutic strategies based on enrichment designs that allow capturing efficacy of uncommon oncogenic molecular targets with prominent actionability.

美国临床病理学会，美国病理学家学会，分子病理学会和美国临床肿瘤学会最近共同发布了生物标志物在结直肠癌（CRC）评估中的指南。¹在本文中，作者支持将RAS突变作为对EGFR靶向单克隆抗体反应的阴性预测进行测试，而建议使用BRAF突变和错配修复（MMR）状态作为其预后价值和林奇综合症预兆。出乎意料的是，未考虑人表皮生长因子受体2（HER2，也称为ERBB2）扩增。^1个与其他肿瘤一样，在转移性CRC中，迫切需要将经过验证的预后或预测性生物标志物与证据不足的其他标志物区分开。但是，分子生物标志物的领域正在迅速发展，精密医学的新范例暗示了基于富集设计的治疗策​​略，这些设计可以捕获具有显着可操作性的罕见致癌分子靶标的功效。