Predictive Biomarkers for Anti-Epidermal Growth Factor Receptor Therapy: Beyond KRAS Testing

In an era of personalized medicine, an increased effort is being made to identify patients likely to benefit from targeted therapy. By limiting treatment to selected patients, both unnecessary cost and toxicity may be avoided. Restricting the use of anti–epidermal growth factor receptor (anti-EGFR)–targeted agents in metastatic colorectal cancer to only patients with KRAS exon 2 wild-type tumors has become well-established in clinical practice. However, lack of KRAS exon 2 mutations does not necessarily predict response, and a significant proportion of patients with KRAS wild-type tumors do not benefit from therapy with cetuximab or panitumumab. Further characterization is needed of the subset of patients with KRAS exon 2 wild-type tumors who are likely to benefit from anti-EGFR therapy. Recent data suggest that patients with KRAS mutations at loci other than exon 2, and those with other RAS mutations, might not benefit from EGFR-directed therapy. This article briefly reviews established work on KRAS exon 2 mutations, but focuses primarily on emerging data on non–exon 2 KRAS mutations and additional RAS and BRAF mutations and how this information may impact clinical decision-making.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Summarize emerging data on non-exon 2 KRAS mutations, NRAS mutations, and BRAF mutations, and how these data may impact clinical decision-making
  • Identify established predictive markers for cetuximab and panitumumab
  • Discuss the clinical implications of data regarding potential new biomarkers for anti-EGFR therapy
Additional information
Supporters: 

No commercial support was received for this article.

Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
10/13/2014
Course expires: 
10/13/2015
Cost:
$0.00

Noman Ashraf, MD
Department of Hematology/Oncology
University of South Florida and James A. Haley VA Hospital
Tampa, Florida

Nishi Kothari, MD
Moffitt Cancer Center
Tampa, Florida

Richard Kim, MD
Moffitt Cancer Center
Tampa, Florida

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
10/13/2014
Course expires: 
10/13/2015

Price

Cost:
$0.00
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Required Hardware/software

To access this activity, users will need:

  • A device with an Internet connection
  • Adobe Reader or other PDF reader software for article and certificate viewing/printing