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Epidermal Growth Factor Receptor (EGFR) sebagai Sasaran Terapi Kanker Kolorektal (Epidermal Growth Factor Receptor (EGFR) as Therapeutic Target in Colorectal Cancer)

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Colorectal cancer is the fourth most frequent malignant disease in the world. Estimation of new cases and mortality are 1.023000 and 529.000 annually. There is an increase of colorectal cancer in Indonesia, but no exact number available. The problems in management of colorectal cancer are patients came in advanced stage, refractory cytostatics regiment, adverse reaction to cytostatics. Alternative strategy uses an agent that act at specific site; for instance Epidermal Growth Factor Receptor (EGFR) inhibitor. EGFR have specific ligand including EGF(epidermal growth factor), bfgf (basic fibroblast growth factor), VEGF (vascular endothelial growth factor) and TGF-_(transforming growth factor- _ ). They have important role in growth dan survival of colorectal cancer. EGFR expression in colorectal cancer. EGFR expression in colorectal cancer is associated with aggressive disease and poor prognosis. EGFR stimulates tumor growth and progression through several mechanism i.e. proliferation, angiogenesis, invasion, metastasis, apoptosis inhibition, adhesion and differentiation. EGFR is specific rational target. Monoclonal antibody (mAbs) directed against EGFR though several mechanism: (1) extracellular binding; (2) internalization of receptor-anti-body complexes; (3) inhibition of EGFR signaling pathways; and (4) potential stimulation of an immunological response. Tyrosine kinase inhibitors (TKls) directed against EGFR through several mechanisms (1) intracellular binding; (2) prevention of tyrosine kinase activation; and (3) inhibition of EGFR signaling pathways. There are many trials of cetuximab as EGFR inhibitor. Cetuximab as EGFR inhibitor. Cetuximab is known as IMC-25 or C255, monoclonal antibody chimeric that is specifically rirected against EGFR. The Food and Drug Administration and Swisss Medical Control Agency approved cetuximab for the irinotecan-refractory colorectal cancer Bevacizumab is humanized antibody that inhibit VEGF action. The Food and Drug Administration aporved the use bevacizumab in combination with any intravenous fluorouracil – containing regimen as initial therapy for patients with advanced colorectal cancer. There is small gefitinib trial for colorectal cancer treatment.

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Cermin Dunia Kedokteran,36(1):5-12

Publisher

Jakarta : Kalbe Farma., 2009

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8p

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0125-913X

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