How Do We Make Choices in Salvage Therapy: Panitumumab, Cetuximab, or Regorafenib?
Colorectal cancer is the fourth commonest cancer worldwide. The survival rate is suboptimal for patients with metastatic disease. The introduction of anti-epidermal growth factor receptor (EGFR) antibodies has remarkably improved clinical outcomes. Two monoclonal antibodies targeting EGFR and one multikinase inhibitor have been approved by the FDA and Health Canada for the treatment of metastatic colorectal cancer; however, only about 10 % of patients respond to this treatment. Having wild-type KRAS is necessary but not sufficient to derive benefit from EGFR inhibition. Interestingly, patients with certain mutations such as p.G13D represent a cetuximab-sensitive subtype of KRAS mutant metastatic colorectal cancer. A few biomarkers have been identified, but we still do not know the best way to administer drugs. In this article we review the clinical data and expert opinions and summarize the recommendations.
KeywordsColorectal cancer KRAS BRAF Cetuximab Panitumumab Regorafenib Anti-epidermal growth factor receptor therapy
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Conflict of Interest
Elena Tsvetkova declares that she has no conflict of interest.
Timothy R. Asmis has received compensation for service as a consultant from Bristol-Myers Squibb and Amgen, is supported by grants from Bristol-Myers Squibb, Amgen, and Bayer, has received payment for lectures, including service on speakers bureaus, from Bristol-Myers Squibb, and currently holds stock in Amgen.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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