CtDNA-guided rechallenge with anti-EGFR therapy in RASwt metastatic colorectal cancer: Evidence from clinical practice

被引：5

作者：

D'Onofrio, Raffaella ^{[1
]}

Caputo, Francesco ^{[1
]}

Prampolini, Francesco ^{[2
]}

Spallanzani, Andrea ^{[1
]}

Gelsomino, Fabio ^{[1
]}

Bettelli, Stefania ^{[3
]}

Manfredini, Samantha ^{[3
]}

Bonetti, Luca Reggiani ^{[4
]}

Carotenuto, Pietro ^{[5
,6
]}

Bocconi, Alessandro ^{[1
]}

Dominici, Massimo ^{[1
]}

Luppi, Gabriele ^{[1
]}

Salati, Massimiliano ^{[1
,7
]}

机构：

[1] Univ Hosp Modena, Dept Oncol & Hematol, Div Oncol, Modena, Italy

[2] Univ Hosp Modena, Dept Radiol, Modena, Italy

[3] Modena Univ Hosp, Mol Pathol, Modena, Italy

[4] Univ Modena & Reggio Emilia, Azienda Osped Univ Policlin, Dept Med & Surg Sci Mothers Children & Adults, Modena, Italy

[5] Telethon Inst Genet & Med, TIGEM, Naples, Italy

[6] Univ Naples Federico II, Dept Translat Med Sci, Med Genet, Naples, Italy

[7] Univ Modena & Reggio Emilia, PhD Program Clin & Expt Med, Modena, Italy

来源：

TUMORI JOURNAL | 2023年 / 109卷 / 04期

关键词：

Colorectal cancer; circulating tumor DNA; anti-EGFR; RAS status; rechallenge; precision medicine; liquid biopsy; ACQUIRED-RESISTANCE; MONOCLONAL-ANTIBODIES; LIQUID BIOPSY; PHASE-II; CETUXIMAB; PANITUMUMAB; EVOLUTION; TRIAL; REGORAFENIB; RETREATMENT;

D O I：

10.1177/03008916221122554

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim: To apply extended ctDNA-based RAS genotyping to clinical criteria for improving the selection of patients eligible for anti-EGFR-based rechallenge in a real-world setting. Methods: ctDNA testing was prospectively applied to RASwt mCRC progressed after a first-line anti-EGFR-containing regimen and at least one other line. The primary endpoint was the objective response rate. Results: Among ten enrolled patients, the anti-EGFR rechallenge resulted in an objective response rate and disease control rate of 70% and 90%. The median progression-free survival was 11.3 months and overall survival was not reached. Compared with a historical cohort retreated with anti-EGFR agents based on clinical criteria, the ctDNA-driven approach resulted in a higher chance of achieving an objective response and longer survival. Conclusions: Blood-based RASwt status may enrich metastatic colorectal cancer more likely to benefit from anti-EGFR-based rechallenge. RAS genotyping in ctDNA represents a feasible, fast, and cost-effective tool to be implemented in the clinic for advancing precision medicine.

引用

页码：387 / 393

页数：7

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