miRNA pharmacogenetics in colorectal cancer: First clinical insights

The identification of predictive biomarkers represents a big challenge in oncology, where the available drugs have low therapeutic index, with high risk of toxicity and low efficacy in many cases. Pharmacogenetics of miRNAs represents a new and still poorly explored field in oncology that can potentially provide clinicians with useful tools in treatment personalization. Colorectal cancer (CRC) is nowadays one of the most compelling emergencies in public health due to its huge diffusion in Western countries. Here we summarized the most updated results from miRNAs' pharmacogenetic studies in CRC. The tumor expression of Let7 family of miRNAs seems to play a key role in CRC tumor response to both fluoropyrimidines and cetuximab. Furthermore, a dysregulated tumor expression of Dicer, a key factor in the miRNA processing machinery, seems to represent predictive marker of tumor response in CRC. Although requiring further prospective clinical validation, these miRNA related pharmacogenomic biomarkers can pave the way to new strategies for treatment personalization in CRC.