Nationwide evaluation of mutation-tailored anti-EGFR therapy selection in patients with colorectal cancer in daily clinical practice
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...
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creator | Steeghs, Elisabeth M P Vink, Geraldine R Elferink, Marloes A G Voorham, Quirinus J M Gelderblom, Hans Nagtegaal, Iris D Grünberg, Katrien Ligtenberg, Marjolijn J L Drillenburg, P Nijhuis, E W P van de Vijver, M J van Noesel, C J Bloemena, E Heideman, D A M Radonic, T Thunissen, E Nederlof, P M Meijer, G A Monkhorst, K Doornewaard, H Dijk, M C R F van Ruijter, E Duthoi, K Meijers, C van de Brule, A J C Nooijen, P T G A Bot, F J Hazalbag, H M Clahsen, P van Nederveen, F H Westenend, P J Jeuken, J W M Ahsmann, E J M Meulbroek, P Timens, W Schuuring, E van Kempen, L C Geuken, W Bulkmans, N W J Bellot, F E Clarijs, R Riemersma, S van der Geize, R Meijer, J van Slooten, H J Kibbelaar, R E van der Logt, E M J van Wezel, T Morreau, H Bovee, J V M G Zur Hausen, A Speel, E J M de Bruin, P C Huijsmans, C J Dusseljee, S Willems, R W Prinsen, C F Zomer, S van Kemenade, F J Dinjens, W N M Geurts-Giele, W R R van der Valk, H Smits, A J J Hoogduin, K J Kliffen, M den Bakker, M A Stavast, J van Diest, P J de Leng, W W J de Bruïne, A P Hinrichs, J W J Meischl, C Gaal, J Niemantsverdriet, M |
description | 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 |
doi_str_mv | 10.1136/jclinpath-2021-207865 |
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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.</description><identifier>ISSN: 0021-9746</identifier><identifier>ISSN: 1472-4146</identifier><identifier>EISSN: 1472-4146</identifier><identifier>DOI: 10.1136/jclinpath-2021-207865</identifier><identifier>PMID: 34675090</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and Association of Clinical Pathologists</publisher><subject>Biomarkers ; Cancer therapies ; Clinical medicine ; Colorectal cancer ; colorectal neoplasms ; Data collection ; Datasets ; Departments ; diagnostic techniques and procedures ; Genes ; Metastasis ; molecular ; Mutation ; Pathology ; Patients ; Short Report ; Tumors</subject><ispartof>Journal of clinical pathology, 2022-10, Vol.75 (10), p.706-711</ispartof><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-b429t-bcff725347fe124b119b5c440cfa998a873770e18f7e10da7740aee91bf711993</cites><orcidid>0000-0003-1290-1474</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9510427/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9510427/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34675090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steeghs, Elisabeth M P</creatorcontrib><creatorcontrib>Vink, Geraldine R</creatorcontrib><creatorcontrib>Elferink, Marloes A G</creatorcontrib><creatorcontrib>Voorham, Quirinus J M</creatorcontrib><creatorcontrib>Gelderblom, Hans</creatorcontrib><creatorcontrib>Nagtegaal, Iris D</creatorcontrib><creatorcontrib>Grünberg, Katrien</creatorcontrib><creatorcontrib>Ligtenberg, Marjolijn J L</creatorcontrib><creatorcontrib>Drillenburg, P</creatorcontrib><creatorcontrib>Nijhuis, E W P</creatorcontrib><creatorcontrib>van de Vijver, M J</creatorcontrib><creatorcontrib>van Noesel, C J</creatorcontrib><creatorcontrib>Bloemena, E</creatorcontrib><creatorcontrib>Heideman, D A M</creatorcontrib><creatorcontrib>Radonic, T</creatorcontrib><creatorcontrib>Thunissen, E</creatorcontrib><creatorcontrib>Nederlof, P M</creatorcontrib><creatorcontrib>Meijer, G A</creatorcontrib><creatorcontrib>Monkhorst, K</creatorcontrib><creatorcontrib>Doornewaard, H</creatorcontrib><creatorcontrib>Dijk, M C R F van</creatorcontrib><creatorcontrib>Ruijter, E</creatorcontrib><creatorcontrib>Duthoi, K</creatorcontrib><creatorcontrib>Meijers, C</creatorcontrib><creatorcontrib>van de Brule, A J C</creatorcontrib><creatorcontrib>Nooijen, P T G A</creatorcontrib><creatorcontrib>Bot, F J</creatorcontrib><creatorcontrib>Hazalbag, H M</creatorcontrib><creatorcontrib>Clahsen, P</creatorcontrib><creatorcontrib>van Nederveen, F H</creatorcontrib><creatorcontrib>Westenend, P J</creatorcontrib><creatorcontrib>Jeuken, J W M</creatorcontrib><creatorcontrib>Ahsmann, E J M</creatorcontrib><creatorcontrib>Meulbroek, P</creatorcontrib><creatorcontrib>Timens, W</creatorcontrib><creatorcontrib>Schuuring, E</creatorcontrib><creatorcontrib>van Kempen, L C</creatorcontrib><creatorcontrib>Geuken, W</creatorcontrib><creatorcontrib>Bulkmans, N W J</creatorcontrib><creatorcontrib>Bellot, F E</creatorcontrib><creatorcontrib>Clarijs, R</creatorcontrib><creatorcontrib>Riemersma, S</creatorcontrib><creatorcontrib>van der Geize, R</creatorcontrib><creatorcontrib>Meijer, J</creatorcontrib><creatorcontrib>van Slooten, H J</creatorcontrib><creatorcontrib>Kibbelaar, R E</creatorcontrib><creatorcontrib>van der Logt, E M J</creatorcontrib><creatorcontrib>van Wezel, T</creatorcontrib><creatorcontrib>Morreau, H</creatorcontrib><creatorcontrib>Bovee, J V M G</creatorcontrib><creatorcontrib>Zur Hausen, A</creatorcontrib><creatorcontrib>Speel, E J M</creatorcontrib><creatorcontrib>de Bruin, P C</creatorcontrib><creatorcontrib>Huijsmans, C J</creatorcontrib><creatorcontrib>Dusseljee, S</creatorcontrib><creatorcontrib>Willems, R W</creatorcontrib><creatorcontrib>Prinsen, C F</creatorcontrib><creatorcontrib>Zomer, S</creatorcontrib><creatorcontrib>van Kemenade, F J</creatorcontrib><creatorcontrib>Dinjens, W N M</creatorcontrib><creatorcontrib>Geurts-Giele, W R R</creatorcontrib><creatorcontrib>van der Valk, H</creatorcontrib><creatorcontrib>Smits, A J J</creatorcontrib><creatorcontrib>Hoogduin, K J</creatorcontrib><creatorcontrib>Kliffen, M</creatorcontrib><creatorcontrib>den Bakker, M A</creatorcontrib><creatorcontrib>Stavast, J</creatorcontrib><creatorcontrib>van Diest, P J</creatorcontrib><creatorcontrib>de Leng, W W J</creatorcontrib><creatorcontrib>de Bruïne, A P</creatorcontrib><creatorcontrib>Hinrichs, J W J</creatorcontrib><creatorcontrib>Meischl, C</creatorcontrib><creatorcontrib>Gaal, J</creatorcontrib><creatorcontrib>Niemantsverdriet, M</creatorcontrib><creatorcontrib>PATH Consortium Members</creatorcontrib><title>Nationwide evaluation of mutation-tailored anti-EGFR therapy selection in patients with colorectal cancer in daily clinical practice</title><title>Journal of clinical pathology</title><addtitle>J Clin Pathol</addtitle><addtitle>J Clin Pathol</addtitle><description>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.</description><subject>Biomarkers</subject><subject>Cancer therapies</subject><subject>Clinical medicine</subject><subject>Colorectal cancer</subject><subject>colorectal neoplasms</subject><subject>Data collection</subject><subject>Datasets</subject><subject>Departments</subject><subject>diagnostic techniques and procedures</subject><subject>Genes</subject><subject>Metastasis</subject><subject>molecular</subject><subject>Mutation</subject><subject>Pathology</subject><subject>Patients</subject><subject>Short 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Marloes A G ; Voorham, Quirinus J M ; Gelderblom, Hans ; Nagtegaal, Iris D ; Grünberg, Katrien ; Ligtenberg, Marjolijn J L ; Drillenburg, P ; Nijhuis, E W P ; van de Vijver, M J ; van Noesel, C J ; Bloemena, E ; Heideman, D A M ; Radonic, T ; Thunissen, E ; Nederlof, P M ; Meijer, G A ; Monkhorst, K ; Doornewaard, H ; Dijk, M C R F van ; Ruijter, E ; Duthoi, K ; Meijers, C ; van de Brule, A J C ; Nooijen, P T G A ; Bot, F J ; Hazalbag, H M ; Clahsen, P ; van Nederveen, F H ; Westenend, P J ; Jeuken, J W M ; Ahsmann, E J M ; Meulbroek, P ; Timens, W ; Schuuring, E ; van Kempen, L C ; Geuken, W ; Bulkmans, N W J ; Bellot, F E ; Clarijs, R ; Riemersma, S ; van der Geize, R ; Meijer, J ; van Slooten, H J ; Kibbelaar, R E ; van der Logt, E M J ; van Wezel, T ; Morreau, H ; Bovee, J V M G ; Zur Hausen, A ; Speel, E J M ; de Bruin, P C ; Huijsmans, C J ; Dusseljee, S ; Willems, R W ; Prinsen, C F ; Zomer, S ; van Kemenade, F J ; Dinjens, W N M ; Geurts-Giele, W R R ; van der Valk, H ; Smits, A J J ; Hoogduin, K J ; Kliffen, M ; den Bakker, M A ; Stavast, J ; van Diest, P J ; de Leng, W W J ; de Bruïne, A P ; Hinrichs, J W J ; Meischl, C ; Gaal, J ; Niemantsverdriet, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b429t-bcff725347fe124b119b5c440cfa998a873770e18f7e10da7740aee91bf711993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biomarkers</topic><topic>Cancer therapies</topic><topic>Clinical medicine</topic><topic>Colorectal cancer</topic><topic>colorectal neoplasms</topic><topic>Data collection</topic><topic>Datasets</topic><topic>Departments</topic><topic>diagnostic techniques and procedures</topic><topic>Genes</topic><topic>Metastasis</topic><topic>molecular</topic><topic>Mutation</topic><topic>Pathology</topic><topic>Patients</topic><topic>Short Report</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Steeghs, Elisabeth M P</creatorcontrib><creatorcontrib>Vink, Geraldine R</creatorcontrib><creatorcontrib>Elferink, Marloes A G</creatorcontrib><creatorcontrib>Voorham, Quirinus J M</creatorcontrib><creatorcontrib>Gelderblom, Hans</creatorcontrib><creatorcontrib>Nagtegaal, Iris D</creatorcontrib><creatorcontrib>Grünberg, Katrien</creatorcontrib><creatorcontrib>Ligtenberg, Marjolijn J L</creatorcontrib><creatorcontrib>Drillenburg, P</creatorcontrib><creatorcontrib>Nijhuis, E W P</creatorcontrib><creatorcontrib>van de Vijver, M J</creatorcontrib><creatorcontrib>van Noesel, C J</creatorcontrib><creatorcontrib>Bloemena, E</creatorcontrib><creatorcontrib>Heideman, D A M</creatorcontrib><creatorcontrib>Radonic, T</creatorcontrib><creatorcontrib>Thunissen, E</creatorcontrib><creatorcontrib>Nederlof, P M</creatorcontrib><creatorcontrib>Meijer, G A</creatorcontrib><creatorcontrib>Monkhorst, K</creatorcontrib><creatorcontrib>Doornewaard, H</creatorcontrib><creatorcontrib>Dijk, M C R F van</creatorcontrib><creatorcontrib>Ruijter, E</creatorcontrib><creatorcontrib>Duthoi, K</creatorcontrib><creatorcontrib>Meijers, C</creatorcontrib><creatorcontrib>van de Brule, A J C</creatorcontrib><creatorcontrib>Nooijen, P T G A</creatorcontrib><creatorcontrib>Bot, F J</creatorcontrib><creatorcontrib>Hazalbag, H M</creatorcontrib><creatorcontrib>Clahsen, P</creatorcontrib><creatorcontrib>van Nederveen, F H</creatorcontrib><creatorcontrib>Westenend, P J</creatorcontrib><creatorcontrib>Jeuken, J W M</creatorcontrib><creatorcontrib>Ahsmann, E J M</creatorcontrib><creatorcontrib>Meulbroek, P</creatorcontrib><creatorcontrib>Timens, W</creatorcontrib><creatorcontrib>Schuuring, E</creatorcontrib><creatorcontrib>van Kempen, L C</creatorcontrib><creatorcontrib>Geuken, W</creatorcontrib><creatorcontrib>Bulkmans, N W J</creatorcontrib><creatorcontrib>Bellot, F E</creatorcontrib><creatorcontrib>Clarijs, R</creatorcontrib><creatorcontrib>Riemersma, S</creatorcontrib><creatorcontrib>van der Geize, R</creatorcontrib><creatorcontrib>Meijer, J</creatorcontrib><creatorcontrib>van Slooten, H J</creatorcontrib><creatorcontrib>Kibbelaar, R E</creatorcontrib><creatorcontrib>van der Logt, E M J</creatorcontrib><creatorcontrib>van Wezel, T</creatorcontrib><creatorcontrib>Morreau, H</creatorcontrib><creatorcontrib>Bovee, J V M G</creatorcontrib><creatorcontrib>Zur Hausen, A</creatorcontrib><creatorcontrib>Speel, E J M</creatorcontrib><creatorcontrib>de Bruin, P C</creatorcontrib><creatorcontrib>Huijsmans, C J</creatorcontrib><creatorcontrib>Dusseljee, S</creatorcontrib><creatorcontrib>Willems, R W</creatorcontrib><creatorcontrib>Prinsen, C F</creatorcontrib><creatorcontrib>Zomer, S</creatorcontrib><creatorcontrib>van Kemenade, F J</creatorcontrib><creatorcontrib>Dinjens, W N M</creatorcontrib><creatorcontrib>Geurts-Giele, W R R</creatorcontrib><creatorcontrib>van der Valk, H</creatorcontrib><creatorcontrib>Smits, A J J</creatorcontrib><creatorcontrib>Hoogduin, K J</creatorcontrib><creatorcontrib>Kliffen, M</creatorcontrib><creatorcontrib>den Bakker, M A</creatorcontrib><creatorcontrib>Stavast, J</creatorcontrib><creatorcontrib>van Diest, P J</creatorcontrib><creatorcontrib>de Leng, W W J</creatorcontrib><creatorcontrib>de Bruïne, A P</creatorcontrib><creatorcontrib>Hinrichs, J W J</creatorcontrib><creatorcontrib>Meischl, C</creatorcontrib><creatorcontrib>Gaal, J</creatorcontrib><creatorcontrib>Niemantsverdriet, M</creatorcontrib><creatorcontrib>PATH Consortium Members</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Steeghs, Elisabeth M P</au><au>Vink, Geraldine R</au><au>Elferink, Marloes A G</au><au>Voorham, Quirinus J M</au><au>Gelderblom, Hans</au><au>Nagtegaal, Iris D</au><au>Grünberg, Katrien</au><au>Ligtenberg, Marjolijn J L</au><au>Drillenburg, P</au><au>Nijhuis, E W P</au><au>van de Vijver, M J</au><au>van Noesel, C J</au><au>Bloemena, E</au><au>Heideman, D A M</au><au>Radonic, T</au><au>Thunissen, E</au><au>Nederlof, P M</au><au>Meijer, G A</au><au>Monkhorst, K</au><au>Doornewaard, H</au><au>Dijk, M C R F van</au><au>Ruijter, E</au><au>Duthoi, K</au><au>Meijers, C</au><au>van de Brule, A J C</au><au>Nooijen, P T G A</au><au>Bot, F J</au><au>Hazalbag, H M</au><au>Clahsen, P</au><au>van Nederveen, F H</au><au>Westenend, P J</au><au>Jeuken, J W M</au><au>Ahsmann, E J M</au><au>Meulbroek, P</au><au>Timens, W</au><au>Schuuring, E</au><au>van Kempen, L C</au><au>Geuken, W</au><au>Bulkmans, N W J</au><au>Bellot, F E</au><au>Clarijs, R</au><au>Riemersma, S</au><au>van der Geize, R</au><au>Meijer, J</au><au>van Slooten, H J</au><au>Kibbelaar, R E</au><au>van der Logt, E M J</au><au>van Wezel, T</au><au>Morreau, H</au><au>Bovee, J V M G</au><au>Zur Hausen, A</au><au>Speel, E J M</au><au>de Bruin, P C</au><au>Huijsmans, C J</au><au>Dusseljee, S</au><au>Willems, R W</au><au>Prinsen, C F</au><au>Zomer, S</au><au>van Kemenade, F J</au><au>Dinjens, W N M</au><au>Geurts-Giele, W R R</au><au>van der Valk, H</au><au>Smits, A J J</au><au>Hoogduin, K J</au><au>Kliffen, M</au><au>den Bakker, M A</au><au>Stavast, J</au><au>van Diest, P J</au><au>de Leng, W W J</au><au>de Bruïne, A P</au><au>Hinrichs, J W J</au><au>Meischl, C</au><au>Gaal, J</au><au>Niemantsverdriet, M</au><aucorp>PATH Consortium Members</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nationwide evaluation of mutation-tailored anti-EGFR therapy selection in patients with colorectal cancer in daily clinical practice</atitle><jtitle>Journal of clinical pathology</jtitle><stitle>J Clin Pathol</stitle><addtitle>J Clin Pathol</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>75</volume><issue>10</issue><spage>706</spage><epage>711</epage><pages>706-711</pages><issn>0021-9746</issn><issn>1472-4146</issn><eissn>1472-4146</eissn><abstract>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.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and Association of Clinical Pathologists</pub><pmid>34675090</pmid><doi>10.1136/jclinpath-2021-207865</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-1290-1474</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0021-9746 |
ispartof | Journal of clinical pathology, 2022-10, Vol.75 (10), p.706-711 |
issn | 0021-9746 1472-4146 1472-4146 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9510427 |
source | PubMed Central |
subjects | Biomarkers Cancer therapies Clinical medicine Colorectal cancer colorectal neoplasms Data collection Datasets Departments diagnostic techniques and procedures Genes Metastasis molecular Mutation Pathology Patients Short Report Tumors |
title | Nationwide evaluation of mutation-tailored anti-EGFR therapy selection in patients with colorectal cancer in daily clinical practice |
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