Molecular mechanisms of resistance to the EGFR monoclonal antibody cetuximab

TM Brand, M Iida, DL Wheeler - Cancer biology & therapy, 2011 - Taylor & Francis
TM Brand, M Iida, DL Wheeler
Cancer biology & therapy, 2011Taylor & Francis
The epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase belonging to the
HER family of receptor tyrosine kinases. Receptor activation upon ligand binding leads to
down stream activation of the PI3K/AKT, RAS/RAF/MEK/ERK and PLCγ/PKC pathways that
influence cell proliferation, survival and the metastatic potential of tumor cells. Increased
activation by gene amplification, protein overexpression or mutations of the EGFR has been
identified as an etiological factor in a number of human epithelial cancers (eg, NSCLC …
The epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase belonging to the HER family of receptor tyrosine kinases. Receptor activation upon ligand binding leads to down stream activation of the PI3K/AKT, RAS/RAF/MEK/ERK and PLCγ/PKC pathways that influence cell proliferation, survival and the metastatic potential of tumor cells. Increased activation by gene amplification, protein overexpression or mutations of the EGFR has been identified as an etiological factor in a number of human epithelial cancers (e.g., NSCLC, CRC, glioblastoma and breast cancer). Therefore, targeting the EGFR has been intensely pursued as a cancer treatment strategy over the last two decades. To date, five EGFR inhibitors, including three small molecule tyrosine kinase inhibitors (TKIs) and two monoclonal antibodies have gained FDA approval for use in oncology. Both approaches to targeting the EGFR have shown clinical promise and the anti-EGFR antibody cetuximab is used to treat HNSCC and CRC. Despite clinical gains arising from use of cetuximab, both intrinsic resistance and the development of acquired resistance are now well recognized. In this review we focus on the biology of the EGFR, the role of EGFR in human cancer, the development of antibody-based anti-EGFR therapies and a summary of their clinical successes. Further, we provide an in depth discussion of described molecular mechanisms of resistance to cetuximab and potential strategies to circumvent this resistance.
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