Division of Medical Oncology, Department of Experimental and Clinical Medicine and Surgery F. Magrassi and A. Lanzara, Second University of Naples, Naples, Italy.
Target Oncol. 2009 Dec;4(4):311-22. doi: 10.1007/s11523-009-0129-6. Epub 2009 Nov 14.
Targeted agents have become an integral part of the treatment of a number of malignant diseases and regimens containing agents that disrupt the epidermal growth factor receptor (EGFR) signaling pathway are now considered a standard therapeutic approach for a range of tumor types. Recently, the mutational status of the KRAS gene in tumors was shown to be predictive of outcome to treatment with EGFR-targeted therapies in metastatic colorectal cancer (mCRC). The immoglobulin (Ig) G1 EGFR-targeting monoclonal antibody (mAb), cetuximab, has been shown to provide significant clinical benefits when added to standard irinotecan- and oxaliplatin-containing chemotherapy regimens, first-line, in patients with KRAS wild-type mCRC. Its effects on tumor response and resectability of metastases make cetuximab a particularly useful treatment option for patients with bulky or initially unresectable disease. With an ever-increasing array of management options available, it is important that patients with mCRC receive the treatment that offers them the best chance of prolonged survival. In view of this, testing for tumor KRAS mutation status should be mandatory at diagnosis of mCRC, prior to treatment decision-making.
靶向药物已成为治疗多种恶性疾病的重要组成部分，含有破坏表皮生长因子受体（EGFR）信号通路的药物的方案目前被认为是多种肿瘤类型的标准治疗方法。最近，肿瘤中 KRAS 基因突变状态被证明可预测转移性结直肠癌（mCRC）患者对 EGFR 靶向治疗的反应。IgG1 型 EGFR 靶向单克隆抗体（mAb）西妥昔单抗与标准伊立替康和奥沙利铂化疗方案联合应用时，可显著改善 KRAS 野生型 mCRC 患者的一线治疗效果。西妥昔单抗对肿瘤反应和转移灶可切除性的影响使其成为局部晚期或初始不可切除疾病患者的特别有用的治疗选择。随着管理选择的不断增加，对于 mCRC 患者，获得最有可能延长生存机会的治疗方法非常重要。鉴于此，在治疗决策之前，mCRC 的诊断时应强制检测肿瘤 KRAS 突变状态。
