PRODUCT labels on the class of drugs known as anti-EGFR monoclonal antibodies, specifically cetuximab (Erbitux) and panitumumab (Vectibix) have just been changed to no longer be recommended for the treatment colorectal cancers in patients with mutation KRAS.
The American Cancer Society says about 150,000 Americans will be diagnosed with colorectal cancer in 2009.
The retrospective subset analysis of seven separate randomised trials in patients with colorectal cancers having KRAS mutations, noted a lack of benefit associated with these monoclonal antibodies.
Patients can now be screened for EGFR and KRAS status, and patients with KRAS mutations will not be treated with therapies which are unlikely to provide benefit.
Patients with just EGFR mutations or overexpression will now be treated with anti-EGFR antibodies with a higher certainty of response.
For patients with mutations in KRAS, the good news is that an alternative therapy is currently being developed for them.
An oncolytic virus being developed by Oncolytics Biotech is being designed to kill cancer cells with this particular mutation and with EGFR mutations as well, and is already well-advanced into clinical trials in the U.S. and the U.K.
The virus Reolysin preferentially replicates in cancer cells which have an activated RAS pathway.
Approximately two-thirds of all cancers have an activated RAS pathway, including most metastatic disease. A large number of mutations, including mutations in EGFR, Her2 or KRAS along the RAS pathway lead to RAS pathway activation.
To date, over 280 patients with various forms of cancer have been treated with Reolysin in various trials in Canada, the U.S., and the U.K. Side effects of oncolytic virus treatment are said to be mild compared with those of chemotherapy or radiation.
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