K-ras mutations in colorectal cancer: a practice changing discovery.

摘要: Recent insights into the molecular pathogenesis of colorectal cancer have given rise to specific target-directed therapies, including monoclonal antibodies against epidermal growth factor receptor (EGFR) and vascular endothelial (VEGF). These drugs been approved as second third line therapies for metastatic (mCRC). Activating mutations K-Ras family genes are most common genetic events in tumorigenesis implicated a predictive determining response anti-EGFR pivotal studies. Phase II III trials, conducted investigating role status on treatment, revealed that patients with wild-type had better clinical terms prolonged median progression-free survival overall rates when compared mutant K-Ras. In contrast, mCRC benefit from anti-VEGF treatment irrespective status. Interestingly, combination demonstrates no added value these patients. The studies concluded pretreatment testing offers valuable information deciding options. There several methods mutation detection seem practical enough apply practice. Further confirmatory prospective needed evaluate detections tumor metastases, early stage CRC, method sampling specimens.