Abstract
Antibodies against epidermal growth factor receptor (EGFR)—cetuximab and panitumumab—are widely used to treat colorectal cancer. Unfortunately, patients eventually develop resistance to these agents. We describe an acquired EGFR ectodomain mutation (S492R) that prevents cetuximab binding and confers resistance to cetuximab. Cells with this mutation, however, retain binding to and are growth inhibited by panitumumab. Two of ten subjects studied here with disease progression after cetuximab treatment acquired this mutation. A subject with cetuximab resistance harboring the S492R mutation responded to treatment with panitumumab.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Change history
06 July 2012
In the version of this article initially published, due to an oversight by the authors, the first and last names of one the authors, Somasekar Seshagiri, were incorrectly transposed. The error has been corrected in the HTML and PDF versions of the article.
References
Amado, R.G. et al. J. Clin. Oncol. 26, 1626–1634 (2008).
Karapetis, C.S. et al. N. Engl. J. Med. 359, 1757–1765 (2008).
Van Cutsem, E. et al. N. Engl. J. Med. 360, 1408–1417 (2009).
Bokemeyer, C. et al. J. Clin. Oncol. 27, 663–671 (2009).
Douillard, J.Y. et al. J. Clin. Oncol. 28, 4697–4705 (2010).
Peeters, M. et al. J. Clin. Oncol. 28, 4706–4713 (2010).
Saif, M.W., Kaley, K., Chu, E. & Copur, M.S. Clin. Colorectal Cancer 9, 315–318 (2010).
Acknowledgements
This work was supported by Instituto de Salud Carlos III (ISCIII) -Subdirección General de Evaluación y Fomento de la Investigación (PS09/01491, PI08/0211 and PI09/1285) and Plan Nacional (PN) de Investigación Científica, Desarrollo e Innovación Tecnológica (I+D+I), iniciativa Ingenio 2010, programa Consolider and ISCIII/FEDER (RD06/0020/0109); PN de I+D+I 2008-20011 and DIUE Generalitat de Catalunya (2009 SGR 321) grants. We thank the Fundació Privada Cellex (Barcelona) for a generous donation to the Medical Oncology Service, Hospital del Mar. We thank the Tumor Bank of Pathology of Hospital del Mar (MARBiobanc), which is supported by FEDER (RD09/0076/00036), and Xarxa de Bancs de Tumors de Catalunya, which is sponsored by PDO (XBTC). We thank L. Roth and R. Cook for assistance with the EGFR binding studies, J. Guillory and J. Stinson for DNA sequencing, and J. Yélamos for key discussions.
Author information
Authors and Affiliations
Contributions
C.M. designed the overall project. C.M., A.D., A.R., J.S., F.B. and J.A. designed experiments and analyzed data. A.D. performed cell-line and molecular experiments. B.B. and S.P. performed sequencing. M.C. prepared mutant proteins. M.S. performed the fluorescence in situ hybridization analysis. H.H. and A.M. performed the deep sequencing. S.M., S.P.T. and S. Seshagiri carried out the sequencing experiments and recombinant protein assays. M.I. collected and evaluated the tumor samples. S. Serrano supervised the tumor assays. C.M., M.G. and J.B. collected clinical information on the subjects. C.M., J.S., F.B. and J.A. wrote the manuscript.
Corresponding authors
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Supplementary information
Supplementary Text and Figures
Supplementary Figures 1–6, Supplementary Tables 1 and 2 and Supplementary Methods (PDF 533 kb)
Rights and permissions
About this article
Cite this article
Montagut, C., Dalmases, A., Bellosillo, B. et al. Identification of a mutation in the extracellular domain of the Epidermal Growth Factor Receptor conferring cetuximab resistance in colorectal cancer. Nat Med 18, 221–223 (2012). https://doi.org/10.1038/nm.2609
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/nm.2609
This article is cited by
-
Therapeutic antibodies for the prevention and treatment of cancer
Journal of Biomedical Science (2024)
-
Baseline ctDNA gene alterations as a biomarker of survival after panitumumab and chemotherapy in metastatic colorectal cancer
Nature Medicine (2024)
-
Sequential RAS mutations evaluation in cell-free DNA of patients with tissue RAS wild-type metastatic colorectal cancer: the PERSEIDA (Cohort 2) study
Clinical and Translational Oncology (2024)
-
Network pharmacology‑based investigation of potential targets of triptonodiol acting on non-small-cell lung cancer
European Journal of Medical Research (2023)
-
Structure-guided and phage-assisted evolution of a therapeutic anti-EGFR antibody to reverse acquired resistance
Nature Communications (2022)