Colorectal cancer (CRC) is the second most common cancer in Germany; there are 
more than 70,000 new cases annually. It is most commonly a disease of the 
elderly, and its relative and absolute frequency has risen during the last 
decades. CRC remains a major clinical and health economy challenge. Progress has 
been made in patient management and CRC treatment. Screening colonoscopy was 
introduced in Germany in 2002, and five new therapeutic agents have been 
approved since 2001, i.e. capecitabine, oxaliplatin, cetuximab, bevacizumab and 
panitumumab; guidelines have been published, and 48 interdisciplinary CRC 
centres have been certified in Germany in compliance with DIN EN ISO 9001:2000. 
Despite these advancements, targeted treatment of CRC is still in its infancy. 
Until 2007, no predictive biomarkers were used to tailor the adjuvant or 
palliative chemotherapy of CRC. KRAS genotyping was recently introduced as 
predictive biomarker, since only tumors carrying a wildtype were found to 
respond to treatment with panitumumab. Among the tumors with KRAS wildtype, only 
40-53% (equivalent to 20-30% of all CRC patients) will benefit from treatment, 
and the remainder are still enrolled for "non-targeted" treatment. Thus there is 
still a great need for predictive biomarkers that are able to tailor patient 
treatment at different stages of the disease.