It has made its place and win the argument, in Metastatic Colon cancer, the fight against cancer through the various VEGF receptors cannot be demonstrated better but by what Avastin has achieved. Avastin has won our heart and the argument, and is now part of standard of care for metastatic Colon cancer. It is most of the time Given with Folfox. All Oncologists have had to use this combination of treatment with confidence because it works. Well, for a while, like most any thing you try to do to a cell, suppression of a pathway is survived by amplification or activation of dormant pathways. In a normal cell of adult individuals, anything placental has to be "dormant" or clearly "subliminal". Well think again, if you block the main angiogenic (VEGF1) pathway, you wake up the secondary ones. Among the one you awake, one is striking, The Placental one called PLGF or Placental Growth factor. Not only it is awaken, but it is also stealing the show. If you go to a conference on Colon Cancer these days and no one mention this gene, be assured you went to the wrong conference! Everyone is talking about this PLGF but be careful, inhibition of this one leave the cell without ability to handle " inflammation". If you completely inhibit this one, get ready to fight an (give or take) "eclampsia" looking like syndrome (PLGF is decreased in Pre-eclampsia) . Handle this one with care! But scientist have their eyes on this one. It stole the show from the MTOR inhibitors (MTOR is the other way of developing resistance to VEGF inhibition).(see our previous blogs). Lack of biomarkers is driving researchers from exhausting all options to their fullest benefit! We keep hop-here and hop-there! and see what works!
Suffice is to say that Panitumumab (Vectibix) is looking very good right now with Folfiri as a second line, suggestion is that it is beating Cetuximab (Erbitux) in second line...weigh my word..."suggestion"...
wild type KRAS related of course.
But now the NRAS, we need to dig deep on this one!
In The Kinases, one winner (FDA approved )Regorafenib, we are learning, and patients are waiting!
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