Nationwide evaluation of mutation-tailored anti-EGFR therapy selection in patients with colorectal cancer in daily clinical practice

Steeghs, E.M.P.; Vink, G.R.; Elferink, M.A.G.; Voorham, Q.J.M.; Gelderblom, H.; Nagtegaal, I.D.; ... ; PATH Consortium Members (2021)

Article / Letter to editor

For a nationwide real-word data study on the application of predictive mutation testing of patients with colorectal cancer (CRC) for anti-epidermal growth factor receptor (EGFR) therapy stratification, pathology data were collected from the Dutch Pathology Registry from October 2017 until June 2019 (N=4060) and linked with the Netherlands Cancer Registry. Mutation testing rates increased from 24% at diagnosis of stage IV disease to 60% after 20-23 months of follow-up (p<0.001). Application of anti-EGFR therapy in KRAS/NRAS wild-type patients was mainly observed from the third treatment line onwards (65% vs 17% in first/second treatment line (p<0.001)). The national average KRAS/NRAS/BRAF mutation rate was 63.9%, being similar for next-generation sequencing (NGS)-based approaches and single gene tests (64.4% vs 61.2%, p=ns). NGS-based approaches detected more additional potential biomarkers, for example, ERBB2 amplifications (p<0.05). Therefore, single gene tests are suitable to stratify patients with mCRC for anti-EGFR therapy, but NGS is superior enabling upfront identification of therapy resistance or facilitate enrolment into clinical trials.

• colorectal neoplasms
• pathology
• molecular
• diagnostic techniques and procedures

• All authors: Steeghs, E.M.P.; Vink, G.R.; Elferink, M.A.G.; Voorham, Q.J.M.; Gelderblom, H.; Nagtegaal, I.D.; Grunberg, K.; Ligtenberg, M.J.L.; PATH Consortium Members
• Date: 2021-10-20
• Journal: Journal of Clinical Pathology
• DOI: doi:10.1136/jclinpath-2021-207865
• Link: https://jcp.bmj.com/content/jclinpath/early/2021/10/20/jclinpath-2021-20...