Gad Rennert

Gregory E. Idos

Kevin McDonnell

Frontiers in Oncology

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Frontiers in OncologyOPEN ACCESSEDITED AND REVIEWED BYLiang Qiao,The University of Sydney, Australia*CORRESPONDENCEGregory E. Idosgidos@coh.orgRECEIVED 01 August 2024ACCEPTED 17 September 2024PUBLISHED 10 October 2024CITATIONMcDonnell K, Rennert G and Idos GE (2024)Editorial: Hereditary colorectal cancersyndromes and risk assessment in the era ofprecision medicine.Front. Oncol. 14:1474157.doi: 10.3389/fonc.2024.1474157COPYRIGHT© 2024 McDonnell, Rennert and Idos. This isan open-access article distributed under theterms of the Creative Commons AttributionLicense (CC BY). The use, distribution orreproduction in other forums is permitted,provided the original author(s) and thecopyright owner(s) are credited and that theoriginal publication in this journal is cited, inaccordance with accepted academicpractice. No use, distribution or reproductionis permitted which does not comply withthese terms.TYPE EditorialPUBLISHED 10 October 2024DOI 10.3389/fonc.2024.1474157Editorial: Hereditary colorectalcancer syndromes and riskassessment in the era ofprecision medicineKevin McDonnell 1, Gad Rennert2 and Gregory E. Idos1*1Department of Medicine, City of Hope National Medical Center, Duarte, CA, United States, 2TechnionIsrael Institute of Technology, Technion Israel Institute of Technology, Haifa, IsraelKEYWORDSprecision medicine, hereditary, colorectal cancer, genetic testing, chemopreventionEditorial on the Research TopicHereditary colorectal cancer syndromes and risk assessment in the eraof precision medicineColorectal cancer (CRC) is a significant public health challenge, necessitating ongoingresearch into more effective diagnostic and treatment approaches. The Research Topic,“Hereditary Colorectal Cancer Syndromes and Risk Assessment in the Era of PrecisionMedicine,” explores and showcases the latest advancements in hereditary colorectal cancer(CRC) syndrome diagnosis, treatment, and management, providing a comprehensiveoverview of how precision medicine is transforming CRC care for individuals withgenetic predispositions. The articles in this Research Topic offer cutting-edge insightsinto various aspects of CRC, from novel diagnostic tools to chemoprevention strategies,underlining the importance of precision medicine in enhancing patient outcomes.Dong et al. present a novel approach to preoperative lymph node (LN) metastasisevaluation in rectal cancer. By integrating MRI radiomics with clinical data, they developeda machine learning model that surpasses traditional assessment methods in predicting LNmetastasis, achieving a higher positive predictive value. The findings suggest that thisapproach could significantly aid in tailoring more precise treatment strategies, emphasizingthe clinical utility of combining radiomics with conventional clinical data. This researchexemplifies how precision medicine can enhance non-invasive diagnostic accuracy andassist in tailoring treatment strategies, thus improving management for patients withcolorectal cancer.Building upon this theme of innovative diagnostic techniques, O’Shea et al. introducean advancement in integrating genomic testing into routine oncology practice. Their studypresents a model, derived from comprehensive implementation research, provides astructured approach to improve access to genomic testing for Lynch syndrome. Byaddressing barriers such as funding, infrastructure, and role delineation, and proposingsolutions like embedded genetic counselors and electronic medical record integration, thismodel aims to streamline genetic testing processes. Its successful implementation couldserve as a blueprint for other hereditary cancer syndromes, facilitating broader adoption offrontiersin.org01McDonnell et al. 10.3389/fonc.2024.1474157precision medicine practices. This study aims to integrate precisionmedicine into routine oncology practice, ensuring that individualswith hereditary risks receive timely and accurate genetic testing andsubsequent personalized care.Complementing these advancements in diagnostics and genetictesting, Brand et al. explore the potential of cytokine profiling topredict colorectal cancer risk in Lynch syndrome patients. Byanalyzing normal-appearing colorectal tissue, the study identifiesimmune signatures that distinguish LS patients with a history ofCRC from those without. These findings suggest that immunemicroenvironment profiling could become a valuable tool in CRCrisk assessment and prevention strategies, enabling morepersonalized surveillance and intervention approaches.While Brand et al. focus on risk prediction, another crucialaspect of personalized care for hereditary colorectal cancersyndromes is chemoprevention. In this vein, Mraz et al. providevaluable insights into how chemoprevention is widely discussed andapplied, particularly in Lynch syndrome (LS) and familialadenomatous polyposis (FAP). There remains considerablevariability in the specifics of these practices. Most professionalsrecommend aspirin for LS patients, albeit with no consensus on theoptimal dosage. This heterogeneity underscores the need forstandardized guidelines and further research to optimizechemoprevention strategies, considering individual patient factors tomaximize benefits and minimize risks.As the field of chemoprevention continues to evolve, so too doesour understanding of genetic risk factors. Highlighting this progression,Li et al. demonstrate the critical role of genetic testing in hereditarycancer syndromes through their identification of a novel splicingvariant in the MSH2 gene. This study not only confirms thepathogenicity of the MSH2 c.793-1G>A variant throughbioinformatics and functional assays but also underscores theimportance of regular surveillance for mutation carriers. Suchgenetic insights are vital for early detection and prevention ofCRC in at-risk populations. By confirming the pathogenicity ofthis variant, this study supports the role of precision medicine inidentifying genetic mutations and highlights the need for regularsurveillance and personalized risk assessment for mutation carriers.Moving from genetic risk factors to the broader molecular landscapeof colorectal cancer, Luo et al. offer new perspectives on the molecularunderpinnings of colon cancer through their exploration ofcuproptosis-related genes. By identifying distinct molecularsubtypes associated with different tumor microenvironmentcharacteristics and treatment responses, their research contributesto the development of more tailored therapeutic strategies. This studyFrontiers in Oncology 02exemplifies how precision medicine can guide the development ofpersonalized treatment options for patients with hereditarypredispositions to colon cancer, further emphasizing the importanceof molecular profiling in advancing CRC care.These studies collectively underscore the rapidly evolvinglandscape of CRC diagnosis and treatment, driven byadvancements in genomics, radiomics, and immunology. Bypresenting these diverse contributions, we aim to provide acomprehensive overview of how precision medicine is reshapingour approach to hereditary CRC syndromes. Looking ahead, it willbe crucial to continue validating these findings through large-scale,multicenter studies and to develop standardized guidelines for theirclinical implementation. The integration of these innovativeapproaches holds promise for significantly improving patientoutcomes and reducing the burden of colorectal cancer globally.By embracing the principles of precision medicine, healthcareproviders can offer more targeted and effective care, ultimatelytransforming the management of colorectal cancer and otherhereditary cancer syndromes.Author contributionsGI: Writing – original draft, Writing – review & editing. GR:Writing – review & editing. KM: Writing – review & editing.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that could beconstrued as a potential conflict of interest.The author(s) declared that they were an editorial boardmember of Frontiers, at the time of submission. This had noimpact on the peer review process and the final decision.Publisher’s noteAll claims expressed in this article are solely those of the authorsand do not necessarily represent those of their affiliatedorganizations, or those of the publisher, the editors and thereviewers. Any product that may be evaluated in this article, orclaim that may be made by its manufacturer, is not guaranteed orendorsed by the publisher.frontiersin.org

Editorial: Hereditary colorectal cancer syndromes and risk assessment in the era of precision medicine

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Editorial: Hereditary colorectal cancer syndromes and risk assessment in the era of precision medicine

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