What is ColoAlert®?

For those with a curious mind and fancy some bedtime story.

I enclose some extra information about ColoAlert in a scientific context

What is ColoAlert®?

ColoAlert® is a non-invasive stool test for the early detection of colorectal cancer. A laboratory analysis examines the patient’s stool sample taken at home for occult blood and tumour markers. The mechanics of the ColoAlert® test is based on the fact that healthy cells as well as cancer cells are shed into the stool. Those cells can then be used as diagnostic markers as many publications demonstrated [4, 5] . Stool samples from patients with CRC have also a much higher amount of human DNA (hDNA). The quantification of the amount of hDNA relative to the total stool DNA combined with the presence of the tumour cells is proven to be a reliable marker for the early detection of the bowel cancer [6, 7] . In the presence of the disease, the ColoAlert® stool test can then detect the tumour cells that have been shed in the colon mucosa. With the help of tumour cell markers different point mutations in genes related to the bowel cancer development can be detected: 17 different KRAS point mutations (Codons 12/13), 10 BRAF point mutations (Protein kinase Codons 600/6001) [4, 5] combined with the quantification of hDNA and complementary detection of the occult blood (FIT).

KRAS is a small G protein that acts as a transducer in the EGFR signalling pathway. This G protein belongs to the GTPase RAS superfamily and triggers the crucial signalling cascades like the MAPK kinase cascade involved in cell growth, proliferation, differentiation, or survival. These cascades play a key role in tumorigenesis when they are aberrantly activated due to the point mutations [6] . It is considered one of the most important players in human cancers. Point mutations in KRAS are present in 50% of patients with CRC. BRAF encodes a cytoplasmic serinethreonine kinase that acts immediately downstream of KRAS and MAPK signalling pathway, while its aberrant activation enhances cell proliferation and survival. The incidence of the BRAF mutation in metastatic CRC is only 10% but it is considered a very relevant therapeutic target for CRC management. The concomitant KRAS and BRAF mutations also play a very important role in the therapy as these mutations increase the resistance to the chemotherapy and specifically to the new antibody therapy using monoclonal antibodies against EGFR or VEGFR. Thus, the concomitant presence of the KRAS and BRAF mutations are not only very reliable markers for an early detection of CRC but as well a very good tool for the mCRC therapy management improving the outcome for the patients.

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