Patient Encounter Part 4 Screening and Preventing Colon Cancer

GW is concerned about his twin boys developing colon cancer given his disease and his family history of cancer. He asks for advice on preventing colon cancer and ways to detect the disease earlier in his children.

What is the role for chemoprevention for GW's children?

What are the screening recommendations for colon cancer?

Do these change for GW's children?

Recent data have demonstrated specific tumor characteristics that may assist clinicians in predicting who may respond to these agents. Early IHC staining for EGFR status is not useful in predicting response as both EGFR-positive and -negative pa tients response at the same rate. Fluorescence in situ hybridization (FISH) of EGFR copy number and KRAS gene mutation status have recently demonstrated predictive value. Patients with high EGFR gene copy number and wild-type (nonmutated) KRAS are more likely to benefit from cetuximab or panitumumab therapy.41,44 In particular, testing for KRAS mutational status is now part of the disease workup to define patients who may derive benefit from cetuximab or panitumumab. Most clinical trials currently underway are now stratifying patients based on KRAS status to further assist clinicians in defining appropriate therapy for this subset of patients.

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