ADVANCES IN ONCOLOGY Current Developments in the Management of Solid Tumor Malignancies

摘要

WM KRAS testing has been around for approximately 3 years, and it is a good example of how quickly there is uptake of new information into the field of oncology. Most oncologists were incorporating KRAS testing even before the US Food and Drug Administration (FDA) changed the labels on cetuximab (Erbitux, Eli Lilly/ Bristol-Myers Squibb) and panitumumab (Vectibix, Amgen). These days, it is rare to see a colorectal cancer patient whose KRAS mutation status is not known, especially one who has advanced colorectal cancer. In the adjuvant setting, we usually do not collect information on KRAS mutational status because monoclonal antibodies targeting the epidermal growth factor receptor (EGFR) are not effective in this situation. However, in advanced disease, KRAS testing has become the standard of care, determining eligibility for cetuximab and panitumumab. It is important to remember that KRAS testing is a negative predictive test, meaning that if a patient is KRAS wild-type, it does not necessarily mean that he or she will benefit from EGFR-targeting agents, and if the patient is KRAS mutant-at least codon 12 KRAS-mutant-the patient will not derive benefit from and should not receive EGFR-targeting agents.