Some colon caner tumors show amplification of HER2 molecule. When to use HER2 inhibitors in colon cancer treatment? Herceptin and lapatinib (Tykerb) are HER inhibitors for use in colorectal cancer treatment. How to combine HER2 inhibitors with other chemotherapy in colon cancer treatment?
Another colon cancer treatment target is the HER2 overexpression. Dr. Anton Titov, MD. We know HER2 gene from breast cancer and from gastric cancer. Trastuzumab antibody targets HER2 very well. Trastuzumab is also used with oral tyrosine kinase inhibitors in colon cancer treatments. Prof. Dr. Hans-Joachim Schmoll, MD. Combination of trastuzumab with lapatinib has been extensively studied. Lapatinib is an oral tyrosine kinase inhibitor of HER2. Treatment with Trastuzumab and Lapatinib without any additional chemotherapy was highly effective. It was used as last-line treatment in colon cancer patients who over-expressed HER2. Trastuzimab and Lapatinib will now be tested as first-line colon cancer treatment. Dr. Anton Titov, MD. It worked very strongly without classic chemotherapy in last line treatment of colon cancer. we hope it will work even better as first-line colon cancer therapy. So, this is personalized targeted therapy for 5% of the colon cancer patient population. Then we have another 5% of colon cancer patiwnts with BRAF mutation. we have 50% with KRAS or NRAS mutation. we have more and more molecular subgroups of colon cancer patients. Each subgroup deserves different treatment. Not only as last-line therapy. But as a first-line colon cancer therapy. We are changing from a broad and general treatment of colon cancer. Prof. Dr. Hans-Joachim Schmoll, MD. We are now taking molecular-based treatment decisions in colon cancer. Treatment combination is tailored for the molecular profile of colon cancer tumor. Dr. Anton Titov, MD. It is not tailored for the patient, like a real precision medicine treatment. As I said before, it is tailored for the molecular profile of the tumor. Targeted HER2 colon cancer therapy is probably going to be more effective and less toxic than classical chemotherapy. It is a reason why are use these targeted treatments. Prof. Dr. Hans-Joachim Schmoll, MD. Perhaps not at the beginning of colon cancer treatment. But using effective targeted therapy from the start of treatment is more relevant. It is more important for long-term survival of patients with colorectal cancer. it is important to use the most effective medications right at the beginning of colon cancer treatment. To choose effective targeted therapy right after the diagnosis. Treatment based on the molecular profile of the tumor and genetic profile of the patient. Certainly. Yes. at the same time we have to look for more targets for development of new medications. Prof. Dr. Hans-Joachim Schmoll, MD. We can treat colon cancer with available medications. But we have to develop new medications. we have to use tumor mutations as targets for new medications. Selection of therapy should be done based on the molecular profile of the tumor. Dr. Anton Titov, MD. Selection of therapy should not be based on the anatomical originating organ of the tumor. Absolutely right. Colorectal cancer treatment with Herceptin and Lapatinib (Tykerb) HER2 inhibitors . Herceptin and Lapatinib in colon cancer treatment can be very effective. Therapeutic dual inhibition of HER2 pathway in metastatic colon cancer has to be used more often. SIRT in metastatic colorectal cancer uses also HER2 inhibitors. Lapatinib (Tykerb/Tyverb) is an oral tyrosine kinase inhibitor of HER2. Trastuzimab (Herceptin) and Lapatinib (Tykerb/Tyverb) can be tested as first-line colon cancer treatment. We are progressing in personalized colon cancer therapy. Targeted HER2 colon cancer therapy is probably going to be more effective and less toxic than classical chemotherapy. Treatment with Trastuzumab (Herceptin) and Lapatinib did not require classical chemotherapy. colon cancer patients who over-expressed HER2 were treated with Herceptin and Lapatinib. Leading colorectal cancer expert discusses HER2 inhibition in colon cancer therapy with Herceptin (trastuzumab) and Lapatinib.