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29.10.2018 | Systemic Therapies in Colorectal Cancer (RD Kim, Section Editor) | Ausgabe 6/2018

Current Colorectal Cancer Reports 6/2018

The Role of HER2 Testing in Advanced Colorectal Cancer

Zeitschrift:
Current Colorectal Cancer Reports > Ausgabe 6/2018
Autor:
Rutika Mehta
Wichtige Hinweise
This article is part of the Topical Collection on Systemic Therapies in Colorectal Cancer

Abstract

Purpose of Review

About 1/3 of all metastatic colorectal cancer (mCRC) patients may harbor a mutation in the KRAS or NRAS gene suggesting inefficacy of EGFR inhibitors cetuximab and panitumumab. In spite of tailoring treatment in RAS wild-type patients to receive EGFR inhibitors, not all show response.

Recent Findings

Studies have shown that HER2-neu amplification/alteration in addition to alteration in BRAF and PI3KA may explain resistance to EGFR inhibitors. Several pre-clinical studies have identified that HER2-neu amplification can result in both de novo and acquired resistance to EGFR inhibitors. Recently, several clinical studies have highlighted the use of single or combination HER2-neu directed therapies in HER2-neu amplified/overexpressed mCRC.

Summary

About 5% mCRC patients will demonstrate HER2-neu overexpression and response to HER2-neu-directed therapies can be in the range of 30–38%. Patients not responding to EGFR-inhibitors warrant testing for HER2-neu testing to explain resistance. In the near future, HER2-neu testing is likely to be integrated into our routine clinical practice for management of metastatic colorectal cancer patients.

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