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Clin Colorectal Cancer. 2011 Dec;10(4):325-32. doi: 10.1016/j.clcc.2011.03.028. Epub 2011 May 11.

Is there a role for IGF1R and c-MET pathways in resistance to cetuximab in metastatic colorectal cancer?

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1
Division of Medical Oncology, Catholic University of the Sacred Heart, Rome, Italy.

Abstract

BACKGROUND:

The KRAS mutation is not responsible for all cases of resistance to anti-epidermal growth factor receptors (EGFRs) in metastatic colorectal cancer (mCRC), and new predictive and prognostic factors are actively being sought.

PATIENTS AND METHODS:

We retrospectively evaluated the efficacy of a cetuximab-containing treatment in 73 patients with mCRC according to KRAS and BRAF mutational status as well as PTEN, c-MET, and insulin-like growth factor receptor (IGF1R) expression.

RESULTS:

Overall response rate (ORR), median progression-free survival (mPFS), and median overall survival (mOS) were significantly lower in patients with KRAS mutation than in patients with KRAS wild-type; among the population with KRAS wild-type, only 2 patients with BRAF mutations were found and neither of them achieved a response. No significant association was found between PTEN and clinical outcome. Compared with low/normal expression, c-MET overexpression significantly correlated with shorter mPFS and mOS: 3 vs. 5 months (P = .018) and 11 vs. 10 months (P = .037), respectively. In patients with high IGF1R expression, mOS was significantly longer than in those with low/normal expression (14 vs. 8 months; P = .015).

CONCLUSION:

KRAS mutation significantly correlates with a worse outcome in patients treated with cetuximab, whereas no definitive inference can be drawn about the role of BRAF mutation and PTEN loss of expression. Instead, c-MET overexpression might represent a negative prognostic factor in mCRC and may have a role in resistance to anti-EGFR therapy. Interestingly, IGF1R overexpression seems a favorable prognostic factor in mCRC.

PMID:
21729677
DOI:
10.1016/j.clcc.2011.03.028
[Indexed for MEDLINE]
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