Implications for KRAS status and EGFR-targeted therapies in metastatic CRC

Nicola Normanno, Sabine Tejpar, Floriana Morgillo, Antonella De Luca, Eric Van Cutsem, Fortunato Ciardiello

Research output: Contribution to journalArticle

Abstract

EGFR regulates cancer-cell proliferation, apoptosis and tumor-induced neoangiogenesis, and has been validated as a relevant therapeutic target in several human cancers, including metastatic colorectal cancer (mCRC). The anti-EGFR monoclonal antibodies cetuximab and panitumumab are available for the treatment of patients with mCRC. Although EGFR is expressed in approximately 85% of patients with mCRC, the clinical efficacy of treatment with anti-EGFR antibodies is limited to a subset of patients. A series of potential biomarkers that could be useful in predicting response to EGFR inhibitors has been investigated. In patients with mCRC, activating mutations within KRAS can predict resistance to anti-EGFR monoclonal antibodies. Activating mutations in KRAS, which could result in EGFR-independent intracellular signal transduction activation, are found in approximately 35-40% of patients with mCRC. These mutations are almost exclusively detected in codons 12 and 13 of exon 2. KRAS mutations have been significantly associated with lack of response to cetuximab or panitumumab therapy in patients with mCRC, which suggests that EGFR-independent, constitutive activation of the RAS signaling pathway could impair response to anti-EGFR drugs. We summarize the experimental and clinical evidence supporting the use of KRAS testing for the optimal selection of patients with mCRC to be treated with anti-EGFR monoclonal antibodies.

Original languageEnglish
Pages (from-to)519-527
Number of pages9
JournalNature Reviews Clinical Oncology
Volume6
Issue number9
DOIs
Publication statusPublished - 2009

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Colorectal Neoplasms
Mutation
Monoclonal Antibodies
Therapeutics
Neoplasms
Codon
Patient Selection
Anti-Idiotypic Antibodies
Exons
Signal Transduction
Biomarkers
Cell Proliferation
Apoptosis
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Oncology

Cite this

Implications for KRAS status and EGFR-targeted therapies in metastatic CRC. / Normanno, Nicola; Tejpar, Sabine; Morgillo, Floriana; De Luca, Antonella; Van Cutsem, Eric; Ciardiello, Fortunato.

In: Nature Reviews Clinical Oncology, Vol. 6, No. 9, 2009, p. 519-527.

Research output: Contribution to journalArticle

Normanno, Nicola ; Tejpar, Sabine ; Morgillo, Floriana ; De Luca, Antonella ; Van Cutsem, Eric ; Ciardiello, Fortunato. / Implications for KRAS status and EGFR-targeted therapies in metastatic CRC. In: Nature Reviews Clinical Oncology. 2009 ; Vol. 6, No. 9. pp. 519-527.
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