Expert Point of View: Neal J. Meropol, MD

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Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Case Medical Center at Case Western Reserve University, Cleveland, discussed the various findings in RAS mutations at the Gastrointestinal Cancers Symposium.

RAS mutations beyond exon 2 are common, occurring in about 15% to 18% of patients, and patients with any RAS mutations do not appear to benefit—at least in a major way—from anti-EGFR treatment,” he emphasized. “I do believe it’s time to adopt more extensive RAS testing in our patients with colorectal cancer.”

“Among patients with no RAS mutations, a clinically meaningful survival benefit was observed with cetuximab [Erbitux] compared with bevacizuimab [Avastin] in FIRE-3, but no difference in progression-free survival. Results of the ongoing Alliance 80405 trial are of great interest in this regard,” he added. “Currently, the incomplete data regarding potential biologic differences when combining different EGFR inhibitors with different chemotherapy backbones, and between different RAS mutations, awaits further augmentation of the dataset. Pooled analysis of all available studies is encouraged.” ■

Disclosure: Dr. Meropol has received consulting fees from Precision Therapeutics.

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