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  • 1 Országos Onkológiai Intézet, 1122, Budapest, Ráth György u. 7–9.
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Absztrakt

A vastag- és végbélrák karcinogenezise során a korai adenómákban az esetek közel felében K-RAS-, ennél ritkábban B-RAF-mutáció alakul ki. A K-RAS-mutáns daganatok inkább férfiakban alakulnak ki, míg a B-RAF-mutáns tumorok inkább nőkre jellemzőek és e gének mutációja független a mikroszatellita-státusztól. Az epidermális növekedési faktor receptorának (EGFR) változó mértékű expressziója a vastag- és végbélrákok döntő hányadában kimutatható; maga a gén nem mutált, amplifikációja igen ritka, gyakrabban a megfelelő kromoszóma poliszómiája miatt fokozott a kópiaszám. Ez képezte alapját az anti-EGFR antitest-terápiák bevezetésének a vastag- és végbélrákok kezelésébe. E terápiák indikációjának alapját sokáig az EGFR fehérje legalább minimális szintű expressziója jelentette. A két antitest-terápia kemoterápia-rezisztens kolorektális rákok monoterápiája esetén hasonló mértékű (kb. 10%) objektív tumorválaszt eredményez, mely független a daganat EGFR-státuszától. A panitumumab esetében fény derült azonban arra, hogy a kedvező klinikai hatás csak a K-RAS-mutáns daganatos csoportban mutatkozik. A cetuximab kombináció­ja kemoterápiával az eddigi adatok alapján szintén a vastag- és végbélrákok K-RAS-mutációs státuszától függ. Mindezek alapján megállapítható, hogy az EGFR-t célzó monoterápiák negatív predikciós markere vastag- és végbélrákban a K-RAS onkogén mutációja. Mindaddig, amíg nem rendelkezünk hatékonyabb betegszelekciós módszerrel, a vastag- és végbélrákok K-RAS-mutációs státuszának meghatározását el kell végezni az EGFR-t célzó terápiák alkalmazása előtt.

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Magyar Onkológia
Language Hungarian
Size  
Year of
Foundation
1956
Publication
Programme
 
Volumes
per Year
 
Issues
per Year
 
Founder Magyar Onkológusok Társasága
Founder's
Address
H-1122 Budapest, Hungary Ráth György u. 7-9.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 0025-0244 (Print)
ISSN 2060-0399 (Online)