RAS Mutations Beyond KRAS Exon 2: A Review and Discussion of Clinical Trial Data

摘要: The addition of targeted therapy to a 5-FU chemotherapy backbone is now standard care in metastatic colorectal cancer. Epidermal growth factor receptor (EGFR) inhibitors have been demonstrated improve progression-free survival (PFS) and overall (OS) the first line for patients with tumors that do not harbor KRAS exon 2 mutations. Eligibility criteria most clinical trials involving EGFR recent years used absence mutation as sole entry, this specific has consistently shown be predictive poor response inhibitors. However, expanded analyses first-line reveal other RAS mutations, such mutations exons 3 4, along NRAS are responses well. Testing full panel these should done prior initiating treatment an inhibitor. Further required determine impact each individual To date, they analyzed aggregate. therapy, bevacizumab or inhibitor, considered all appropriate patients. relevant evaluated without any compared inhibitor alone show distinct advantage groups received inhibition. largest trial line, CALGB/SWOG 80405, did statistically significant difference between two groups, making use bevacizumab, cetuximab, panitumumab reasonable line.