Colon Cancer Month: Guideline Helps Guide Targeted Therapy Decisions and Patient Care

Mar 28, 2018

A pivotal guideline that addresses testing a range of molecular biomarkers in patients with early and advanced colorectal cancer has had a tremendous impact since it was released last year. The Molecular Biomarkers for the Evaluation of Colorectal Cancer guideline has helped to establish standard molecular biomarker testing, guide targeted therapy decisions, and advance personalized care for patients with colorectal cancer.

“I hear lab directors and oncologists citing it frequently, whenever the question is raised about the most appropriate molecular tests to order on patients with colon cancer,” said Wayne W. Grody, MD, PhD, FASCP, UCLA School of Medicine, project co-chair on behalf of ASCP. “The guideline has brought a sense of unity to a field that was previously quite disparate, with no clear consensus on which of the many available molecular tests truly have clinical relevance.”

March is designated as National Colon Cancer Awareness Month to bring attention to the disease and support the work that is being done. Colorectal cancer is the second leading cause of cancer-related death in the U.S. for women and men combined. In 2018, more than 135,000 people will be diagnosed with colon cancer, a highly treatable disease when discovered early.

The guideline was developed by ASCP in collaboration with the College of American Pathologists (CAP), the Association for Molecular Pathology (AMP), and the American Society of Clinical Oncology (ASCO). Guidelines are routinely updated because the nature of the molecular diagnostic science keeps changing.

 “Molecular medicine—of which molecular pathology is a major component—is the most rapidly evolving area in clinical practice.  So any guideline about the most appropriate molecular tests and technologies for any medical application is going to require frequent updating,” Dr. Grody said, adding, “DNA sequencing technologies are continually being refined and costs are dropping, while the number of targets for such tests are continually increasing and becoming better characterized by further basic research on the molecular biology of malignant tumors.  That is why we will need to be planning for the second generation of our colon cancer guideline.”

 Development of the guideline brought together stakeholders together representing the medical laboratory and pathology professions, as well as clinician and patient interests. The three pathology societies who partnered in developing this guideline felt it was crucial to enlist the clinical oncology community in the deliberations, since they are the ones who often order these molecular tests on their patients. A representative of ASCO was recruited as one of the co-chairs of this effort. 

 “I believe this approach gave the resulting document a great deal more credibility and universal acceptance—since it was not merely a result of pathologists speaking only among themselves,” Dr. Grody said.

To read more about the guideline, click here.