title: Patient-tailored treatments with anti-EGFR monoclonal antibodies in advanced colorectal cancer: KRAS and beyond.
abstract: Personalized medicine emphasizes the practice of considering individual patient characteristics as opposed to that centered on standards derived from epidemiological studies which, by definition, do not take into account the variability of individuals within a given population. When applied to oncology, personalized medicine is an even more complex concept because it extends the variability beyond the individual patient to the individual tumor. Indeed, the great genotypic and phenotypic variability (both in primary and metastatic sites of cancer) the development of targeted therapies, and the growing availability of biological assays complicate the scenario of personalized medicine in the oncological field. In this paper we review the results of anti-epidermal growth factor receptor (EGFR) monoclonal antibody (mAb) therapy in metastatic colorectal cancer (mCRC) in the context of tumor biology, delineating the future prospects of patient-tailored medicine in this area. In particular, we deal with EGFR inhibition by Cetuximab, a chimeric mouse human IgG1 mAb, and panitumumab, a fully human IgG2 mAb. We discuss the clinical impact of anti-EGFR mAbs on wild-type (WT) KRAS mCRC, also taking into account the feasibility of novel multi-marker approaches to treatment decision-making, aimed at increasing the predictive power of pre-therapy biomarkers. Experimental topics and fields of ongoing research, such as targeting microRNAs (miRNAs) with novel anticancer drugs and epigenetics in CRC are also addressed.
authors.affiliation: Division of Semeiotics and Medical Methodology, Department of Internal Medicine, University of Genoa, Italy. aballestrero@unige.it
authors.forename: A
authors.initials: A
authors.lastname: Ballestrero
authors.forename: A
authors.initials: A
authors.lastname: Garuti
authors.forename: G
authors.initials: G
authors.lastname: Cirmena
authors.forename: I
authors.initials: I
authors.lastname: Rocco
authors.forename: C
authors.initials: C
authors.lastname: Palermo
authors.forename: A
authors.initials: A
authors.lastname: Nencioni
authors.forename: S
authors.initials: S
authors.lastname: Scabini
authors.forename: G
authors.initials: G
authors.lastname: Zoppoli
authors.forename: S
authors.initials: S
authors.lastname: Parodi
authors.forename: F
authors.initials: F
authors.lastname: Patrone
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis / Q000235:genetics; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D044127:Epigenesis, Genetic; D066246:ErbB Receptors / Q000037:antagonists & inhibitors* / Q000235:genetics; D006801:Humans; D051379:Mice; D035683:MicroRNAs / Q000378:metabolism; D009154:Mutation; D000077544:Panitumumab; D057285:Precision Medicine; D011518:Proto-Oncogene Proteins / Q000032:analysis / Q000037:antagonists & inhibitors / Q000378:metabolism; D016283:Proto-Oncogene Proteins p21(ras); D051381:Rats; D016896:Treatment Outcome; D018631:ras Proteins / Q000032:analysis / Q000037:antagonists & inhibitors / Q000378:metabolism
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; C117307:KRAS protein, human; D035683:MicroRNAs; D011518:Proto-Oncogene Proteins; D000077544:Panitumumab; C512478:EGFR protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins; D000068818:Cetuximab