Should Anti-EGFR Agents Be Used in Right-Sided RAS Wild-type Advanced Colorectal Cancer?

AbstractPurpose of ReviewColorectal cancer is the third most common cancer worldwide with a high mortality rate at the advanced stages of the disease. Treatment options are dependent on the stage of the disease, patients ’ performance status, and the specific molecular makeup of the tumor. Adding an anti-epidermal growth factor receptor monoclonal antibody (anti-EGFR mAb) to conventional chemotherapy in molecularly selected patients (i.e., RAS wild-type) leads to a survival advantage. We aim to review the latest e vidence on the influence of primary tumor location (PTL) on treatment response to chemotherapy combined with an anti-EGFR in patients with metastatic colorectal cancer (mCRC).Recent FindingsColon cancer arising on the left side versus the right side of the colon portrays different outcomes, emerging PTL as an important characteristic in understanding the outcomes for patients with colorectal cancer. Patients with right-sided tumors have a worse prognosis than those with left-sided tumors. Primary tumor location may also be predictive of treatment benefit from targeted therapy with an anti-EGFR or anti-VEGF in the treatment of RAS wild-type mCRC. Although no benefit in overall survival (OS) has been demonstrated, available data up to now can endorse the use of an anti-EGFR in right-sided RAS wild-type advanced colorectal cancer if the therapy goal is tumor shrinkage (given the higher objective response rate). However, the majority of data on PTL has been obtained t...
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research