(1) Department of Medical Oncology, University and General Hospital, Piazzale S Maria della Misericordia 15, 33100, Udine, Italy
(2) Department of Pathology and Molecular Biology, University and General Hospital, Piazzale S Maria della Misericordia 15, 33100, Udine, Italy
* Corresponding author Email: email@example.com
In the past 15 years, the treatment of advanced colorectal cancer has markedly advanced, leading to a median survival improvement from 1 year with 5-Fluorouracil alone to over 24 months with modern therapies. Recently, we have learned that specific genomic alterations have a clear prognostic role and are closely linked to response to specific anticancer agents. Specifically, antibodies targeting the epidermal growth factor receptor pathway have produced sounding survival improvements for advanced colorectal cancer patients. To optimise their use, however, a more profound knowledge of tumour molecular oncology is crucial. In this short viewpoint the authors depict the biological, clinical and economic relevance of v-Raf murine sarcoma viral oncogene homologue B1 and extended rat sarcoma mutational analyses when focusing on epidermal growth factor receptor inhibitor-based therapy.
Colorectal cancer patients who are most likely to benefit from epidermal growth factor receptor inhibitors may be selected with a deeper molecular biology, encompassing not only exon 2 Kirsten rat sarcoma viral oncogene homologuemutations (codons 12 and 13), but also neuroblastoma rat sarcoma viral oncogene homologue and BRAF mutational status. This fine-tuning in patients’ selection has produced striking implications.