Mutations in the Kirsten rat sarcoma viral oncogene homolog (KRAS) gene are a well-described mechanism of resistance to monoclonal antibodies that target the epidermal growth factor receptor in patients with metastatic and nonoperable colorectal cancer. Treatment options in this population are limited to conventional chemotherapy regimens and antiangiogenesis compounds. Numerous strategies have been proposed in preclinical models as being effective in the presence of KRAS mutations. As basic and translational research further unravels the complex interactions and regulation points in the pathways downstream of epidermal growth factor receptor, more drugs become available for clinical testing. Indeed, there are many ongoing clinical trials that focus on the safety and efficacy of novel compounds in patients with KRAS-mutated colorectal cancer. This is a review of the literature with regard to the rationale of various approaches on this topic and also a summary of the current active clinical trials limited to patients with KRAS-mutated colorectal cancer.
aDepartment of Pathology, Yale University School of Medicine
b3rd Department of Medicine, University of Athens, Medical School
cDivision of Hematology/Oncology at the Herbert Irving Comprehensive Cancer Center, at Columbia University, College of Physicians and Surgeons, New York, USA
Correspondence to Muhammad Wasif Saif, MD, MBBS, Section of GI Cancers and Pancreas Center, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA Tel: +1 212 305 4954; fax: +1 212 305 03035; e-mail: mws2138@columbia.edu
Received November 1, 2010
