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BRAF and codon 12 KRAS mutations predict for adverse outcome of CRC patients receiving cetuximab.
In colon cancer, KRAS and BRAF mutations predict for resistance to cetuximab.
In lung cancer for instance, catalytic domain EGFR mutations predict for sensitivity to small-molecule tyrosine kinase inhibitors.
If certain gene mutations predict for resistance to specific drugs, the key target for future studies should be to outline these mechanisms in vivo.
Based on the hypothesis that KRAS G12C or G12V mutations predict for better response to selumetinib+docetaxel compared with other KRAS mutations, the following KRAS mutation groups (MGs) were assessed: MG1 (KRAS G12C or G12V); MG2 (all KRAS mutations other than G12C or G12V).
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None of the mutations predicted for a response to treatment.
However, the most interesting question remains: will a PIK3CA mutation predict for increased sensitivity to a PI3K inhibitor?
A BRAF mutation predicted for but did not guarantee a response, whereas a neuroblastoma RAS viral oncogene homolog mutation or wild-type BRAF conferred resistance.
To date, the conclusions of these studies have been mixed with some studies finding that a KRAS mutation predicts for worse response and outcome while others have found no difference based on KRAS mutation status [21 24].
Although no single mutation predicted for response, SF3A1 (n=3) and DNMT3A (n=4) were only observed in non-responders.
In addition to determining whether PIK3CA mutation predicts for the eventual development of resistance, there is a critical need to understand how frequently PIK3CA mutations occur after patients develop resistance to HER2 inhibitor treatment.
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