NRAS is a member of the RAS family of genes that include KRAS and HRAS. A normal NRAS gene teams up with a group of proteins as an “on/off” switch to monitor cell growth. This abnormality is known as a driver mutation because it causes the switch to be locked in the “on” position and drives uncontrolled cell growth, leading a cancer tumor to form. NRAS mutations are found in about 5% of colorectal cancer patients. Patients with NRAS-mutated colorectal cancer should receive chemotherapy (some examples are FOLFOX, CAPOX, and FOLFIRI), with or without Bevacizumab (an antibody that inhibits the growth of blood vessels and oxygen supply in the tumor).
PIK3CA is a gene that is involved in several different processes in cell growth. A PIK3CA mutation is a driver mutation that drives the growth of cells. It exists in many types of cancer and in 10-20% of colorectal cancers. Patients with PIK3CA-mutated colorectal cancer should receive standard chemotherapy. There is at least one drug being used successfully in PIK3CA-mutated breast cancer and it has opened up clinical trials for other PIK3CA-mutated solid tumors, including colorectal cancer.
The UGT1A1 gene is present in all the cells in our body. The normal UGT1A1 gene provides instructions for making a certain enzyme (called UDP glucuronosyltransferases) that helps the liver break down medications effectively. If you have a mutation in the UGT1A1 gene, your body may not be able to process certain chemotherapy drugs. Patients with this rare mutation have symptoms such as impaired liver function, low white cell counts, and severe diarrhea. Your doctor will monitor you closely during your chemotherapy treatment to watch for any adverse reactions.
People with RAS-mutated metastatic colorectal cancer (mCRC) have seen little progress in first-line treatment options over the past two decades, but that could soon change for thousands of new patients, according to a press release from Cardiff Oncology.
Not all tumors are the same, even if they are within the same cancer type. In other words, two people with colorectal cancer may actually have different types of colorectal cancer in terms of the cells that make up their tumors.
If you have colorectal cancer that has spread to the liver, you may want to consider Hepatic Artery Infusion (HAI) therapy. HAI therapy is an FDA-approved cancer treatment that delivers a concentrated dose of medicine into the liver through the hepatic artery. Unlike systemic chemotherapy, HAI therapy is delivered only to the tumor site in the liver, so it does not add additional systemic side effects to the rest of the body.