Consensus recommendations for the use of anti-EGFR therapies in metastatic colorectal cancer

In January 2010, a panel of Canadian oncologists with particular expertise in colorectal cancer (CRC) gathered to develop a consensus guideline on the use of therapies against the epidermal growth factor receptor (EGFR) in the management of metastatic CRC (mCRC). This paper uses a case-based approach to summarize the consensus recommendations developed during that meeting. These are the consensus recommendations: Testing for the KRAS status of the tumour should be performed as soon as an EGFR inhibitor is being considered as an option for treatment. Anti-EGFR therapies are not recommended for the treatment of patients with tumours showing mutated KRAS status. For a patient with wild-type KRAS and an Eastern Cooperative Oncology Group status of 0-2, whose mCRC has previously been treated with a fluoropyrimidine, irinotecan, and oxaliplatin, switching to an EGFR inhibitor is a recommended strategy. Cetuximab, cetuximab plus irinotecan, and panitumumab are all options for third-line therapy in patients with wild-type KRAS , provided that tolerability is acceptable.