Molecularly profiling colorectal cancer has opened many potential opportunities for the use of this information in therapeutic decision-making. However, at present, only RAS testing in the metastatic setting has a definitive place in the decision-making paradigm.
Improved early detection of prostate cancer would ideally involve a noninvasive test that allows clinicians to distinguish aggressive cancers from relatively indolent ones. This distinction is especially important given that relatively few men who undergo screening are destined to die of prostate cancer.
For those undergoing screening for the presence of previously undiagnosed prostate cancer, the major challenge for new tests is to avoid the overdetection of indolent cancers that limits the clinical utility of the prostate-specific antigen (PSA) test.
The benefit-to-risk trade-offs associated with PSA screening are highly sensitive to patient preference, underscoring the importance of ensuring that men have the opportunity to decide for themselves whether they wish to have their individual risk for suffering and death from prostate cancer assessed through PSA screening.
It was originally hoped that the presence of mutations in KRAS and other related genes would provide an easy answer as to whether to administer anti-EGFR antibody therapy to a given metastatic colorectal cancer patient. However, in nature nothing is simple, and there are a number of issues that practicing clinicians should be made aware of.