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EGFR and downstream genetic alterations in KRAS/BRAF and PI3K/AKT pathways in colorectal cancer: implications for targeted therapy.

Abstract
The promise of individualized treatment is gradually being fulfilled, and targeted therapy is becoming a powerful strategy to treat selected patients based on their molecular profile. For metastatic colorectal cancer (mCRC) patients anti-EGFR (epidermal growth factor receptor) targeted therapy has markedly improved disease control and survival. However, only a subgroup of patients with mCRC respond to anti-EGFR treatment, and selecting the patients with a positive effect from treatment is important for both the patient and the society. Patients with mutations in the KRAS gene are known as non-responders to anti-EGFR treatment and, consequently, KRAS testing has been employed in routine clinical practice for patient selection. However, a large number of the KRAS wildtype patients do not respond to this treatment. The molecular mechanism underlying response is not fully understood, and other members of the KRAS-BRAF pathway and PI3K-AKT pathway are investigated as predictive biomarkers. Furthermore, concordance of mutation status of primary tumors and their corresponding hepatic or pulmonary metastases, as well as treatment-induced mutations, possess another challenge for properly tailoring the appropriate therapy to this patient group. In this review, molecular biomarkers involved in prediction of response to anti-EGFR treatment are discussed.
AuthorsMarianne Berg, Kjetil Soreide
JournalDiscovery medicine (Discov Med) Vol. 14 Issue 76 Pg. 207-14 (Sep 2012) ISSN: 1944-7930 [Electronic] United States
PMID23021375 (Publication Type: Journal Article, Review)
Chemical References
  • Biomarkers
  • Phosphatidylinositol 3-Kinases
  • ErbB Receptors
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • Proto-Oncogene Proteins c-akt
  • ras Proteins
Topics
  • Biomarkers (metabolism)
  • Cell Survival
  • Colorectal Neoplasms (drug therapy, metabolism)
  • ErbB Receptors (metabolism)
  • Gene Expression Regulation, Neoplastic
  • Genes, ras
  • Humans
  • Models, Biological
  • Mutation
  • Neoplasm Metastasis
  • Phosphatidylinositol 3-Kinases (metabolism)
  • Proto-Oncogene Proteins B-raf (metabolism)
  • Proto-Oncogene Proteins c-akt (metabolism)
  • ras Proteins (metabolism)

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