The Currently Incurable Scientist: The Future of anti-EGFR Therapy?

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DK37
Posts: 510
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Location: San Diego

The Currently Incurable Scientist: The Future of anti-EGFR Therapy?

Postby DK37 » Thu Aug 13, 2015 5:06 pm

Hi Everyone,

My next "The Currently Incurable Scientist" monthly column on the Fight Colorectal Cancer website published today.

It is a two-part column called "The Future of anti-EGFR Therapy?"

Part 1 examines the current anti-EGFR therapies approved for KRAS-wild type CRC & areas for potential improvement.
http://fightcolorectalcancer.org/resear ... py-part-1/

Part 2 discusses a few next-generation anti-EGFR strategies currently in clinical trials: "Sym004" and "Imprime PGG".
http://fightcolorectalcancer.org/resear ... py-part-2/

I hope you find these posts informative & useful! The columns are word-count limited, so please feel free to ask follow-up questions in the comments below!

-DK
6/4/2012 Dx Stage 3C CRC @ 40 yo. MSS, KRAS-WT, BRAF-WT, p53-mut
7/12 FOLFOX/FOLFIRI
2/13 NED!
8/13 Enlarged lymphs - Stable
10/14 Stage IV. Lung & Lymph mets. 5-FU+bev
3/15 Cetuximab
11/15 FOLFIRI + bev
11/16 Signs of FOLFIRI resistance (Lymph mets)
1/17 Palliative radiation for resistant mets
2/17 FOLFIRI + bev + Maraviroc (off-label)
3/17 FOLFIRI + Erbitux + Maraviroc (off-label)
MSS-CRC Clinical Trial Finder: http://trialfinder.fightcrc.org/
2016 Colondar 2.0 Model
DK37 Science Posts List

ieowi
Posts: 202
Joined: Mon Jul 27, 2015 1:27 am

Re: The Currently Incurable Scientist: The Future of anti-EGFR Therapy?

Postby ieowi » Fri Aug 14, 2015 12:23 am

Thank you DK, I always switch Siri to auto read pages and just finished listening to your articles while driving ;).
Thank you for posting them I always learn a lot from your posts.

If you don't mind I have two questions ;

1- from the two future drugs which one is more promising in your opinion ?
2- for patients with no kras wiled mutation is there anything out there that may help them ?
Or future drug ?
Father 58 yo , Colon cancer IV + 4 Lymph. 7/2015
K-ras Mutant,GNAS,FBXW7,PIK3CA, MSI-low
4 cycles irinotecan+FU5
developed abdominal met + lung met...Failed
4 cycle Oxaliplatin+folfox. peri met growing...Failed
unofficial trial !!!

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Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: The Currently Incurable Scientist: The Future of anti-EGFR Therapy?

Postby Nik Colon » Fri Aug 14, 2015 1:30 am

Thanks again DK
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

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DK37
Posts: 510
Joined: Tue Sep 17, 2013 8:31 am
Location: San Diego

Re: The Currently Incurable Scientist: The Future of anti-EGFR Therapy?

Postby DK37 » Fri Aug 14, 2015 10:07 am

ieowi wrote:
If you don't mind I have two questions ;

1- from the two future drugs which one is more promising in your opinion ?
2- for patients with no kras wiled mutation is there anything out there that may help them ?
Or future drug ?


Hi ieowi,

1 - That is a really tough question to answer. I have anecdotally heard of complete response patients on both. They are currently going after different patient populations however, so that may be a better way to guide choice than to try to figure out "which is better in general" based upon very limited information. Sym004 is curently being targetted towards as a "second line" therapy patients who had responded to Erbitux or Vectibix and have become resistant - so if you are in that group, sym004 is currently the one to consider. If you are KRAS-wt and considering going on Erbitux as standard care as your first EGFR-inhibitor, that is a time to consider entering the Imprime PGG trial.

2- to correct terminology "KRAS-wild type" is not a mutation, the term "wild-type" = "non-mutated". But I think you are probably asking about options for KRAS-mutated folks. I posted before some preliminary results (first ~20 patients) on "RRx-001" that showed a pretty high response rate even if KRAS-mutated (just search posts for RRx-001). So that is one to consider which has released clinical data. There are others as well which have released less detailed information that appear KRAS-agnostic. In terms of future drugs, many/most immunotherapies will probably not care about KRAS-status. On the flip side - our own Celine appears to be potentially having activity in the NIH TIL trial ---- not only is she KRAS-mut but the TIL they are using for her is actually targetting her KRAS mutant protein!

Hope that helps,
-DK
6/4/2012 Dx Stage 3C CRC @ 40 yo. MSS, KRAS-WT, BRAF-WT, p53-mut
7/12 FOLFOX/FOLFIRI
2/13 NED!
8/13 Enlarged lymphs - Stable
10/14 Stage IV. Lung & Lymph mets. 5-FU+bev
3/15 Cetuximab
11/15 FOLFIRI + bev
11/16 Signs of FOLFIRI resistance (Lymph mets)
1/17 Palliative radiation for resistant mets
2/17 FOLFIRI + bev + Maraviroc (off-label)
3/17 FOLFIRI + Erbitux + Maraviroc (off-label)
MSS-CRC Clinical Trial Finder: http://trialfinder.fightcrc.org/
2016 Colondar 2.0 Model
DK37 Science Posts List

ieowi
Posts: 202
Joined: Mon Jul 27, 2015 1:27 am

Re: The Currently Incurable Scientist: The Future of anti-EGFR Therapy?

Postby ieowi » Sat Aug 15, 2015 2:28 am

thank you DK37, i am going through what you mentioned :D
Father 58 yo , Colon cancer IV + 4 Lymph. 7/2015
K-ras Mutant,GNAS,FBXW7,PIK3CA, MSI-low
4 cycles irinotecan+FU5
developed abdominal met + lung met...Failed
4 cycle Oxaliplatin+folfox. peri met growing...Failed
unofficial trial !!!


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