Dr. Kopetz on the Biology of Right- Versus Left-Sided CRC

Scott Kopetz, MD, PhD, FACP, associate professor, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the biology of right- versus left-sided colorectal cancer (CRC).

Compelling data show a clear difference between right- and left-sided CRC, but Kopetz says it is also important to understand the biology driving this. A left-sided tumor derives from different embryologic remnants of a hindgut versus a midgut origin. Different tissues form as a result, leading to differences in the environment of the normal gastrointestinal tract around the tumor.

There also appear to be differences in the epigenetics and the methylation that occurs with aging normal epithelium, Kopetz adds. Tumor sidedness also shows differences in the exposure to different carcinogenic bile acids in these patients.