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Understanding molecular mechanisms of tumourigenesis underlies new therapeutic strategies that specifically target tumours. This has led to the evolution of personalised therapy that was first used in breast cancer when hormone receptor status was determined. More recently in colorectal cancer treatment the Epidermal Growth Factor receptor and its tumourigenic role has led to its targeting by using Cetuximab and Panitumumab. Addition of these drugs to existing drug regimes (FOLFOX and FOLFIRI) showed improved respectability rates in patients with liver metastasis. Most recently the Endothelin receptor has been implicated in multiple tumourigenic processes. Interest has grown in using Endothelin A receptor antagonists as adjuvant or combination therapy as suggested by the FOLFERA and FOLFIRI trials currently on-going.