Potential relevant biomarkers can be found at different levels in tumour developmentand disease progression. This thesis is divided into three overarching parts. Colorectalcancer was studied from... Show morePotential relevant biomarkers can be found at different levels in tumour developmentand disease progression. This thesis is divided into three overarching parts. Colorectalcancer was studied from a population-based perspective (part I) to a molecular level,detailed as protein expression (part II) and (epi)genetics (part III), as indicated in Figure 2.In part I the use of adjuvant chemotherapy in patients with locally advanced rectalcancer, who underwent resection after preoperative (chemo)radiotherapy, wasevaluated in a meta-analysis based on individual patient data. Since four randomizedcontrolled trials individually did not end the ongoing debate about the role of adjuvantchemotherapy 14,68-70. In part II the ability by tumour cells to evade the immunerecognition was studied, especially the role of the non-classical HLA class I moleculeHLA-G was studied in detail. In part III, an epigenetic biomarker, LINE-1 methylationlevel, was studied in a dedicated stage II colon cohort. In addition, an establishedgenetic biomarker for colon cancer, MSI, was studied in a large rectal cancer cohort. Show less
The aim of this thesis was to define prognostic and predictive biomarkers in colorectal cancer for improved risk stratification and treatment benefit in the individual patient, with the... Show moreThe aim of this thesis was to define prognostic and predictive biomarkers in colorectal cancer for improved risk stratification and treatment benefit in the individual patient, with the introduction of precision medicine in the near future as the ultimate goal. By __definition, precision medicine is a multi-faceted approach to medicine that integrates molecular and clinical research with patient data and clinical outcome, and places the patient at the center of all elements. This thesis is divided in three parts. In Part one prognostic biomarkers in CRC are investigated, in Part two aspirin treatment and related predictive biomarkers for aspirin treatment benefit in colon cancer are investigated and finally, in Part three, the use of predictive and prognostic biomarkers in clinical practice, its utility and the road to precision medicine are discussed. Show less
