Surgery and OncologySurgery and OncologyХирургия и онкология2949-5857Publishing House ABV Press2610.17650/2220-3478-2014-0-2-18-21REVIEWОБЗОРЫ ЛИТЕРАТУРЫTHE HIGH ACTIVITY OF VECTIBIX IN PATIENTS WITH METASTATIC COLORECTAL CANCER WITH THE RAS WILD-TYPE GENEВЫСОКАЯ АКТИВНОСТЬ ВЕКТИБИКСА У БОЛЬНЫХ МЕТАСТАТИЧЕСКИМ КОЛОРЕКТАЛЬНЫМ РАКОМ С ДИКИМ ТИПОМ ГЕНА RASSemenovN. N.СемёновН. Н.
Russian Federation

Отделение химиотерапии и комбинированного лечения злокачественных опухолей

niksemenov1969@yandex.ruDepartment of Chemotherapy and Combination Treatment for Malignant Tumors, N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowФГБУ «РОНЦ им. Н. Н. Блохина» РАМН, Москва250520143218212502201525022015Copyright ©; 2014, ABV-pressCopyright ©; 2014, АБВ-пресс2014ABV-pressАБВ-прессhttps://onco-surgery.info/jour/about/editorialPolicieshttps://onco-surgery.info/jour/article/view/26

High-efficiency inhibitors of EGFR (panitumumab and cetuximab) in combination with chemotherapy in patients with advanced colorectal cancer is the result of the targeting special group of the patients based on studies of genes. Previously it was shown that the presence of mutation in exon 2 of KRAS gene (40 % of patients) determines the effectivity of this group of drugs. However, the search for additional indicators was continued. The result is that the presence of mutations in exons 3 and 4 of KRAS gene and in exons 2, 3 and 4 of NRAS gene also predict EGFR inhibitors efficacy. These mutations are defined in 10 % of patients. Analysis showed that the efficiency of panitumumab and cetuximab in combination with chemotherapy significantly increased in patients with wild-type KRAS and NRAS.

Высокая эффективность ингибиторов EGFR (панитумумаба и цетуксимаба) в комбинации с химиотерапией (ХТ) у больных распространенным колоректальным раком обусловлена возможностью выделить специальную группу больных на основании исследований генов. Ранее было показано, что наличие мутации во 2-м экзоне гена KRAS (40 % больных) предопределяет неэффективность этой группы препаратов. Тем не менее поиск дополнительных показателей для более целевого назначения ингибиторов EGFR был продолжен. В результате определено, что наличие мутаций в 3-м и 4-м экзонах гена KRAS и во 2, 3 и 4-м экзонах гена NRAS равным образом предопределяет неэффективность ингибиторов EGFR. Эти мутации определяются у 10 % больных. Проведенный анализ показал, что эффективность панитумумаба и цетуксимаба в сочетании с ХТ значительно увеличивалась у больных с диким типом KRAS и NRAS.

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