Integrating anti-EGFR therapies in metastatic colorectal cancer

Sigurdis Haraldsdottir, Tanios Bekaii-Saab

Research output: Contribution to journalReview articlepeer-review

17 Scopus citations

Abstract

Colorectal cancer remains one of the most common causes of cancer diagnoses and mortality in the United States. The treatment of metastatic colorectal cancer has evolved significantly over the last decade with near-tripling of patient survival rate. A significant contribution to this outcome was the advent of novel targeted agents, such as the epidermal growth factor (EGFR) inhibitors. In an era of emphasis on refining therapy, the presence of KRAS mutation will predict for resistance and limit exposure to patients who are more likely to benefit. In contrast, the presence of BRAF mutations does not seem to have a predictive value. Agents that are thought to reverse resistance to EGFR inhibitors such as those targeting PI3K, c-MET or IGF-1R are currently under study. EGFR inhibitors have exhibited single agent activity, and seem to synergize very well with standard chemotherapy except for cetuximab and 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX). Preliminary data suggests that EGFR inhibitors have similar effectiveness to vascular endothelial growth factor (VEGF) inhibitors in the first line setting. Skin toxicity remains the main limiting factor for the utilization of EGFR inhibitors, but strategies including the use of agents such as minocycline or doxycycline added to topical care seem to limit the severity of the rash.

Original languageEnglish (US)
Pages (from-to)285-298
Number of pages14
JournalJournal of Gastrointestinal Oncology
Volume4
Issue number3
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

Keywords

  • Cetuximab
  • Epidermal growth factor inhibitors (EGFR inhibitor)
  • KRAS
  • Metastatic colorectal cancer (mCRC)
  • Panitumumab
  • Targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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