The HER2 protein is a receptor, which is a microscopic “spike” that sticks out on the surface of almost all the cells in our body. Sometimes there is an abnormality in the cell and multiple HER2 genes are produced, which is called amplification. When the HER2 gene is amplified, it produces excess receptors on the cell surface; this is called overexpression. Overexpression drives uncontrolled growth of the cells, which is how a cancer tumor forms.
KRAS biomarkers are members of the RAS family of genes that include NRAS and HRAS. A normal KRAS gene teams up with a group of proteins as an “on/off” switch to monitor cell growth. An abnormal mutation in the KRAS gene happens early in the development of cancer. Approximately 40-45% of colorectal cancer patients have a KRAS mutation in their tumor. Patients with mutated or unknown KRAS status should receive chemotherapy including FOLFOX, CAPOX, or FOLFIRI with or without bevacizumab.
NRAS is a member of the RAS family of genes that include KRAS and HRAS. A normal NRAS gene teams up with a group of proteins as an “on/off” switch to monitor cell growth. This abnormality is known as a driver mutation because it causes the switch to be locked in the “on” position and drives uncontrolled cell growth, leading a cancer tumor to form. NRAS mutations are found in about 5% of colorectal cancer patients. Patients with NRAS-mutated colorectal cancer should receive chemotherapy (some examples are FOLFOX, CAPOX, and FOLFIRI), with or without Bevacizumab (an antibody that inhibits the growth of blood vessels and oxygen supply in the tumor).
PIK3CA is a gene that is involved in several different processes in cell growth. A PIK3CA mutation is a driver mutation that drives the growth of cells. It exists in many types of cancer and in 10-20% of colorectal cancers. Patients with PIK3CA-mutated colorectal cancer should receive standard chemotherapy. There is at least one drug being used successfully in PIK3CA-mutated breast cancer and it has opened up clinical trials for other PIK3CA-mutated solid tumors, including colorectal cancer.
The UGT1A1 gene is present in all the cells in our body. The normal UGT1A1 gene provides instructions for making a certain enzyme (called UDP glucuronosyltransferases) that helps the liver break down medications effectively. If you have a mutation in the UGT1A1 gene, your body may not be able to process certain chemotherapy drugs. Patients with this rare mutation have symptoms such as impaired liver function, low white cell counts, and severe diarrhea. Your doctor will monitor you closely during your chemotherapy treatment to watch for any adverse reactions.
People with RAS-mutated metastatic colorectal cancer (mCRC) have seen little progress in first-line treatment options over the past two decades, but that could soon change for thousands of new patients, according to a press release from Cardiff Oncology.
Not all tumors are the same, even if they are within the same cancer type. In other words, two people with colorectal cancer may actually have different types of colorectal cancer in terms of the cells that make up their tumors.
If you have colorectal cancer that has spread to the liver, you may want to consider Hepatic Artery Infusion (HAI) therapy. HAI therapy is an FDA-approved cancer treatment that delivers a concentrated dose of medicine into the liver through the hepatic artery. Unlike systemic chemotherapy, HAI therapy is delivered only to the tumor site in the liver, so it does not add additional systemic side effects to the rest of the body.
Immunotherapy is a class of cancer drugs based on biologics that find and destroy colorectal cancer cells. There are different types of immunotherapy, and all immunotherapy works with your immune system to fight cancer.
A pathology report is a medical report that describes the characteristics of a tissue or blood specimen that has been removed from your body. The specimen is analyzed by a pathologist, who writes a report of their findings for the doctor who has ordered the report and/or performed the procedure.
You had probably never even heard of biomarkers until you faced a cancer diagnosis, but they're a very important part of treatment planning. Since every tumor has its own unique pattern of biomarkers, knowing your biomarker profile can help you and your doctor choose the right treatment for your specific tumor.
