Next generation sequencing identifies ‘interactome’ signatures in relapsed and refractory metastatic colorectal cancer

Colorectal cancer (CRC) remains a significant healthcare issue representing the 4th most frequently diagnosed cancer and the second leading cause of cancer mortality in the United States. In 2015 alone, nearly 133,000 estimated new cases of CRC were diagnosed, reflecting eight percent of all new cancer cases. An estimated 49,700 cancer deaths from CRC is predicted in 2015 (1). While the burden of disease is undeniably evident, therapeutic progress is being made in the treatment of CRC. The Center for Disease Control (CDC) has reported that between 2008 and 2011, the incidence of CRC has decreased at a rate of 4% per year. Morality rate has also decreased by nearly 35% in 1990–2007 and in 2011, down by 47% (1,2). This improvement in incidence and overall mortality rate is a function of at least three known improvements in the approach and management of CRC. First, a concerted effort for improved cancer prevention across the nation. Second, increased community awareness through active colorectal screening protocols resulting in prompt diagnosis and referral. Third, a recent surge of FDA approved novel chemotherapeutic and biologic treatment modalities have increased the oncologists’ therapeutic repertoire to manage this disease. Metastatic colorectal cancer (mCRC) represents 20% of newly diagnosed CRC and through a multidisciplinary approach with the utilization of systemic backbone chemotherapy, biologic, targeted therapy and evolving surgical and radiologic interventions, the overall survival (OS) has improved to greater than thirty months