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Updated: Jun 23, 2026
Detection of a Circulating MicroRNA Custom Panel in Patients with Metastatic Colorectal Cancer
Published on: March 14, 2019
ErbB 1-4 expression alterations in primary colorectal cancers and their corresponding metastases
Ingrid Ljuslinder1, Beatrice Malmer, Martin Isaksson-Mettävainio
1Department of Radiation sciences, Oncology, Umeå University Hospital, Umeå University SE-90187 Umeå, Sweden. ingrid.ljuslinder@onkologi.umu.se
Background:
EGFR (epidermal growth factor receptor) targeted therapies are important new tools in colorectal cancer treatment. EGFR analysis of the primary tumour was previously recommended to identify patients who will benefit from the EGFR targeted therapy. Previous studies have displayed diverging results regarding the expression of EGFR in the primary tumour compared to the metastases. The present study was performed to investigate whether EGFR and ErbB2-4 expression differed between 64 primary tumours and their corresponding metastases.
Patients And Methods:
EGFR and ErbB2-4 expression were analysed in the primary tumour and in the corresponding metastases using immunohistochemistry (IHC).
Results:
In 49/64 samples (76%), the primary tumours were EGFR positive; in 33% (16/49) of EGFR positive samples, the tumours lost the EGFR expression in the metastasis compared to the primary tumour. From the primary tumours, 15/64 (23%) were negative and 5 of these (33%) developed EGFR expression in the metastasis. ErbB2, ErbB3, and ErbB4 expression was evident in 54%, 67%, and 81%, respectively. There was no significant difference between ErbB2, ErbB3, and ErbB4 expression in primary tumours and metastases. The co-expression of the ErbB family members was also analysed, with a significant increase of ErbB3/ErbB4 co-expression in late stage tumours.
Conclusion:
The EGFR expression was lost in 33% of metastasising primary colorectal cancer tumours, a finding that agrees with at least one previous study. Thus, the present results clearly implicate the need for EGFR analysis of both the primary tumour and metastases to accurately determine EGFR status when considering the use of EGFR targeted therapies.
Insights
Epidermal growth factor receptor (EGFR) expression can be lost in colorectal cancer metastases. Analyzing both primary tumors and metastases for EGFR is crucial for effective targeted therapy selection.
Area of Science:
- Oncology
- Molecular Biology
Background:
- Epidermal growth factor receptor (EGFR) targeted therapies are vital in colorectal cancer (CRC) treatment.
- Previous research on EGFR expression in primary tumors versus metastases has yielded conflicting results.
- This study investigated differential expression of EGFR and ErbB2-4 between primary CRC tumors and their metastases.
Purpose of the Study:
- To compare EGFR and ErbB2-4 expression levels in primary colorectal tumors and their corresponding metastases.
- To determine the clinical implications of EGFR expression changes in metastatic colorectal cancer.
- To inform patient selection for EGFR-targeted therapies.
Main Methods:
- Immunohistochemistry (IHC) was employed to analyze EGFR and ErbB2-4 expression.
- 64 primary colorectal tumors and their matched metastases were analyzed.
- Expression patterns of EGFR, ErbB2, ErbB3, and ErbB4 were quantified.
Main Results:
- EGFR expression was lost in the metastases of 33% of initially EGFR-positive primary tumors.
- Conversely, 33% of EGFR-negative primary tumors gained EGFR expression in metastases.
- No significant differences in ErbB2, ErbB3, or ErbB4 expression were observed between primary tumors and metastases, though ErbB3/ErbB4 co-expression increased in advanced stages.
Conclusions:
- A significant proportion of colorectal cancers lose or gain EGFR expression during metastasis.
- EGFR analysis of both primary tumors and metastases is essential for accurate patient stratification for EGFR-targeted therapies.
- These findings highlight the dynamic nature of EGFR expression in colorectal cancer progression.
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