Predicting response to EGFR inhibitors in metastatic colorectal cancer: current practice and future directions

Oncologist. 2010;15(2):157-67. doi: 10.1634/theoncologist.2009-0221. Epub 2010 Feb 4.

Abstract

The identification of KRAS mutational status as a predictive marker of response to antibodies against the epidermal growth factor receptor (EGFR) has been one of the most significant and practice-changing recent advances in colorectal cancer research. Recently, data suggesting a potential role for other markers (including BRAF mutations, loss of phosphatase and tension homologue deleted on chromosome ten expression, and phosphatidylinositol-3-kinase-AKT pathway mutations) in predicting response to anti-EGFR therapy have emerged. Ongoing clinical trials and correlative analyses are essential to definitively identify predictive markers and develop therapeutic strategies for patients who may not derive benefit from anti-EGFR therapy. This article reviews recent clinical trials supporting the predictive role of KRAS, recent changes to clinical guidelines and pharmaceutical labeling, investigational predictive molecular markers, and newer clinical trials targeting patients with mutated KRAS.

Publication types

  • Randomized Controlled Trial
  • Review

MeSH terms

  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / pathology
  • ErbB Receptors / antagonists & inhibitors*
  • ErbB Receptors / metabolism
  • Forecasting
  • Genes, ras
  • Humans
  • Mutation
  • Neoplasm Metastasis
  • Predictive Value of Tests
  • Protein Kinase Inhibitors / pharmacology*
  • Protein Kinase Inhibitors / therapeutic use

Substances

  • Protein Kinase Inhibitors
  • ErbB Receptors