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Anti-EGFR Rechallenge in Metastatic Colorectal Cancer and the Role of ctDNA: A Systematic Review and Meta-analysis.
J Gastrointest Cancer
December 2024
Medical Oncology Department, BC Cancer Agency, University of British Columbia, Vancouver, Canada.
Background: Metastatic colorectal cancer (mCRC) remains a significant clinical challenge. While anti-EGFR inhibitors have improved survival rates, their long-term efficacy is limited by disease progression, which is often associated with the development of acquired resistance mutations. However, some patients may regain sensitivity to anti-EGFR agents after alternative therapies, suggesting a potential benefit for rechallenge strategies.
View Article and Find Full Text PDFEfficacy and Safety of Anti-EGFR Therapy Rechallenge in Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.
J Gastrointest Cancer
October 2024
Ophir Loyola Hospital, 66063-240, Belém, PA, Brazil.
Article Synopsis
- * This study conducted a systematic review of 14 studies involving 520 patients to evaluate the safety and efficacy of re-administering anti-EGFR treatments (like cetuximab and panitumumab) to those who previously progressed after treatment.
- * Results indicated a low objective response rate (17.70%) and a moderate disease control rate (61.72%), with notable differences in effectiveness between the types of anti-EGFR therapy used, highlighting the complexities of managing metastatic CRC
Rechallenge with Anti-EGFR Treatment in RAS/BRAF wt Metastatic Colorectal Cancer (mCRC) in Real Clinical Practice: Experience of the GITuD Group.
Target Oncol
July 2024
Medical Oncology Service, Complexo Hospitalario Universitario de Ferrol, A Coruña, Spain.
Background: There are few third- and fourth-line therapeutic options for metastatic colorectal cancer (mCRC). In RAS/BRAF wild-type (wt) mCRC previously treated with anti-epidermal growth factor receptor (anti-EGFR) (first-line) and relapsed after a good response, retreatment with anti-EGFR (rechallenge) emerges as a therapeutic alternative.
Objective: The aim was to show the activity and safety of anti-EGFR rechallenge in RAS/BRAF wt mCRC in real-world practice.
Unveiling acquired resistance to anti-EGFR therapies in colorectal cancer: a long and winding road.
Front Pharmacol
April 2024
Department of Medical Oncology, Hospital del Mar Research Institute, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Barcelona, Spain.
Emergence of acquired resistance limits the efficacy of the anti-EGFR therapies cetuximab and panitumumab in metastatic colorectal cancer. In the last decade, preclinical and clinical cohort studies have uncovered genomic alterations that confer a selective advantage to tumor cells under EGFR blockade, mainly downstream re-activation of RAS-MEK signaling and mutations in the extracellular domain of EGFR (EGFR-ECD). Liquid biopsies (genotyping of ctDNA) have been established as an excellent tool to easily monitor the dynamics of genomic alterations resistance in the blood of patients and to select patients for rechallenge with anti-EGFR therapies.
View Article and Find Full Text PDFAnti-EGFR Rechallenge in Patients With Refractory ctDNA RAS/BRAF wt Metastatic Colorectal Cancer: A Nonrandomized Controlled Trial.
JAMA Netw Open
April 2024
Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
Article Synopsis
- The study examines the effectiveness of anti-EGFR inhibitor rechallenge therapy in patients with refractory RAS/BRAF wild-type metastatic colorectal cancer (mCRC) using data pooled from four Italian trials conducted between 2015 and 2022.
- A total of 114 patients participated, with results showing a 17.5% overall response rate and a disease control rate of 72.3%, indicating some level of effectiveness despite previous treatment struggles.
- The median progression-free survival was reported at 4.0 months and median overall survival at 13.1 months, highlighting the durability of this treatment approach for these patients.
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