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Published on: November 22, 2021
miRNAs as Modulators of EGFR Therapy in Colorectal Cancer
Diane M Pereira1, Cecília M P Rodrigues2
1Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal.
Abstract:
Drug resistance is a serious impediment to the treatment of cancer. The use of anti-epidermal growth factor receptor (EGFR) monoclonal antibody therapies in patients with metastatic colorectal cancer is guided by the presence of activating point mutations in KRAS and NRAS genes in the primary tumour. However, RAS wild-type status is still not sufficient to guarantee response to cetuximab and panitumumab, with response rates limited to 70% for combinations with multidrug chemotherapy. Therefore, additional mechanisms contributing to resistance are currently under investigation, and include genetic alterations and epigenetic mechanisms of resistance. In this regard, deregulation of miRNA expression profiles holds potential to unveil resistance and fuel the development of miRNA-based strategies to overcome EGFR-directed therapy limitations. We discuss current understanding of miRNA impact as modulators of EGFR therapy in patients with metastatic colorectal cancer and the future challenge of miRNAs in circulation as powerful non-invasive tools to monitor anti-EGFR therapy response and predict resistance.
Insights
Drug resistance in colorectal cancer limits anti-EGFR therapy. MicroRNAs (miRNAs) may explain resistance and offer non-invasive monitoring for treatment response and prediction.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Drug resistance is a major challenge in cancer treatment, particularly for metastatic colorectal cancer (mCRC).
- Anti-epidermal growth factor receptor (EGFR) therapies like cetuximab and panitumumab are standard treatments, but their efficacy is limited by intrinsic or acquired resistance.
- While KRAS/NRAS mutations predict resistance, RAS wild-type patients still experience suboptimal response rates, necessitating further investigation into resistance mechanisms.
Purpose of the Study:
- To explore the role of microRNA (miRNA) deregulation in mediating resistance to anti-EGFR therapies in mCRC.
- To investigate the potential of miRNAs as biomarkers for monitoring anti-EGFR therapy response and predicting resistance.
- To highlight the development of miRNA-based strategies to overcome limitations in EGFR-directed cancer therapy.
Main Methods:
- Review of current literature on miRNA expression profiles and their association with anti-EGFR therapy response in mCRC.
- Analysis of genetic and epigenetic mechanisms contributing to drug resistance.
- Exploration of circulating miRNAs as potential non-invasive biomarkers.
Main Results:
- Deregulation of miRNA expression profiles is implicated as a significant factor in resistance to EGFR-targeted therapies.
- miRNAs can modulate the response to EGFR inhibitors, impacting treatment outcomes in mCRC.
- Circulating miRNAs show promise as non-invasive indicators for monitoring treatment efficacy and predicting resistance.
Conclusions:
- miRNA expression profiles are crucial for understanding and potentially overcoming resistance to anti-EGFR therapies in metastatic colorectal cancer.
- Circulating miRNAs represent a valuable, non-invasive tool for real-time monitoring of patient response and prediction of resistance to anti-EGFR treatments.
- Targeting or utilizing miRNAs could lead to improved therapeutic strategies and personalized treatment approaches for mCRC patients.
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