Identified a cause of resistance to colon cancer treatment

Doctors and researchers of Hospital del Mar and its research institute, the IMIM, have lead a study describing a new pharmacological resistance to cancer. This new mechanism is a mutation in an oncogene called EGFR (epidermal growth factor receptor) causing resistance to treatment using a drug called cetuximab, a monoclonal antibody which specifically attacks the EGFR.

The study proves that, both in lab models and in patients with colon cancer, this mutation appears during the disease and that, when this happens, it stops the drug from being effective and the tumor grows. This finding will benefit a large number of patients since colorectal cancer is the second most frequent tumor and cetuximab is a drug used regularly to treat this form of cancer.

Also, another extremely relevant fact is that tumors acquire this mutation do respond to a treatment using another similar drug, called panitumumab, which is also available for clinical use. This carries important clinical implications, since it suggests the possibility of carrying out clinical tests to confirm the effectiveness of panitumumab in patients with colon cancer who no longer respond to cetuximab, this increasing the range of therapies that may be used on patients with this cancer.

The relevance of this study is also in the fact that it is the first time that a mutation is detected in the field of oncology instead of a bond with the antibody as a form of resistance. Therefore, it will be interesting to see whether there are other similar mutations causing resistance to other pharmacological antibodies which are used frequently to treat other forms of cancer, such as breast cancer.

Therefore, this is a completely new mechanism of resistance to a drug used very often for a type of cancer with a high incidence and relevant clinical implications for the treatment of patients with this type of cancer.

"The discovery of this mutation may explain, at a molecular level, the benefits obtained by some patients with colon cancer treated with panitumumab and the inefficiency when treating with cetuximab" explains Clara Montagut, an associate doctor of the Oncology service of Hospital del Mar and a researcher at IMIM, who has lead this study.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) depends on the following:

The stage of the cancer (whether the cancer is in the inner lining of the colon only, involves the whole colon, or has spread to other places in the body).
Whether the cancer has blocked or created a hole in the colon.
Whether there are any cancer cells left after surgery.
The blood levels of carcinoembryonic antigen (CEA; a substance in the blood that may be increased when cancer is present) before treatment begins.