Exploring Predictive and Prognostic Biomarkers in Colorectal Cancer: A Comprehensive Review

Simple Summary Colorectal cancer is a major health concern globally, and finding ways to improve treatment outcomes is crucial. This review explores the role of biomarkers-biological indicators that can predict how a patient will respond to treatment or indicate the likely course of the disease-in managing colorectal cancer. By examining both well-established and emerging biomarkers, we hope to provide a clearer understanding of how these markers can guide personalized treatment plans. The findings from this research could help doctors make more informed decisions, ultimately improving patient care and outcomes in colorectal cancer.Abstract Colorectal cancer (CRC) remains the second leading cause of cancer-related mortality worldwide. While immune checkpoint inhibitors have significantly improved patient outcomes, their effectiveness is mostly limited to tumors with microsatellite instability (MSI-H/dMMR) or an increased tumor mutational burden, which comprise 10% of cases. Advancing personalized medicine in CRC hinges on identifying predictive biomarkers to guide treatment decisions. This comprehensive review examines established tissue markers such as KRAS and HER2, highlighting their roles in resistance to anti-EGFR agents and discussing advances in targeted therapies for these markers. Additionally, this review summarizes encouraging data on promising therapeutic targets and highlights the clinical utility of liquid biopsies. By synthesizing current evidence and identifying knowledge gaps, this review provides clinicians and researchers with a contemporary understanding of the biomarker landscape in CRC. Finally, the review examines future directions and challenges in translating promising biomarkers into clinical practice, with the goal of enhancing personalized medicine approaches for colorectal cancer patients.