EGFR and colon cancer:: a clinical view
EGFR and colon cancer:: a clinical view
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DOI：
10.1007/s12094-008-0147-3
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发表时间：
2008-01-01
影响因子：
3.4
通讯作者：
Gonzalez Baron, Manuel
中科院分区：
文献类型：
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作者：
de Castro-Carpeno, Javier;Belda-Iniesta, Cristobal;Gonzalez Baron, Manuel
从EGFR激活中产生的信号通路在结肠癌(CC)生物学中是至关重要的。它针对特定药物的靶向为这种疾病的治疗打开了一扇新的窗口。在这方面，与酪氨酸激酶抑制剂的无用相比，单抗已经证明了高度的有效性。西妥昔单抗是目前已知的抗CC活性最强的单抗。西妥昔单抗最初被批准为伊立替康耐药性逆转剂后，已经证明了其从一线到大量预治疗患者的有效性。在第一行中，它的加入可能会增加化疗的应答率，提高肝转移瘤的切除率。另一种有希望的方法是将贝伐单抗与联合方案联合使用。Panitumumab最近已被批准用于CC。尽管临床经验有限，但最新的数据已经证实，在经过大量预治疗的患者中，它的活性导致了与最佳支持护理相比的临床益处。尽管有临床上的好处，但这些药物的不良反应和高昂的卫生成本迫使患者选择受益概率最高的患者。目前，当免疫组织化学证实EGFR的表达没有价值时，皮肤毒性，以及从根本上说，K-RAS突变可能暗示着验证性前瞻性研究的关键信息。
Signalling pathways that emerge from EGFR activation are critical in colon cancer (CC) biology. Its targeting with specific drugs has opened a new window in the treatment of this disease. In this regard, monoclonal antibodies (mAb) have evidenced a high degree of efficiency opposed to the uselessness of tyrosine-kinase inhibitors. Cetuximab is the mAb that has evidenced most activity in CC. After its initial approval as an irinotecan-resistance reversal agent, cetuximab has demonstrated its efficiency from the first line to heavily pretreated patients. In the first line, its addition may increase response rate to chemotherapy, improving liver metastases resection rate. Another promising approach has been suggested from combination schedules with bevacizumab. Panitumumab has been recently approved for CC. Although there is limited clinical experience, the latest data have confirmed its activity in heavily pretreated patients resulting in a clinical benefit vs. best support care. In spite of the clinical benefits, adverse events and the high sanitary cost derived from these drugs force the selection of patients with the highest probability of benefit. At the moment, when EGFR expression evidenced by immunohistochemistry has no value, skin toxicity and, fundamentally, K-Ras mutations may hint at critical information for confirmatory prospective studies.