Immunohistochemical evaluation of the prognostic and predictive power of epidermal growth factor receptor ligand levels in patients with metastatic colorectal cancer

Siavash Foroughi, Ryan A. Hutchinson, Hui li Wong, Michael Christie, Ahida Batrouney, Rachel Wong, Margaret Lee, Jeanne Tie, Antony Wilks Burgess, Peter Gibbs

Research output: Contribution to journalArticleResearchpeer-review


For patients with metastatic colorectal cancer (mCRC), epidermal growth factor receptor (EGFR) inhibitors are limited to patients with RAS wild-type tumours. Not all patients will benefit from treatment and better predictive biomarkers are needed. Here we investigated the prognostic and predictive impact of the EGFR ligands amphiregulin (AREG) and epiregulin (EREG). Expression levels were assessed by immunohistochemistry on 99 KRAS wild-type tumours. AREG and EREG positivity was seen in 49% and 50% of cases, respectively. No difference in expression was observed by primary tumour side. There was no significant difference in OS by AREG or EREG expression. In the subset of patients who received an EGFR inhibitor, EREG positivity was associated with longer OS (median 34.0 vs. 27.0 months, p = 0.033), driven by a difference in patients with a left-sided primary (HR 0.37, p = 0.015). Our study supports further investigation into EREG as a predictive biomarker in mCRC.

Original languageEnglish
Pages (from-to)127-136
Number of pages10
JournalGrowth Factors
Issue number3-4
Publication statusPublished - 15 Mar 2021


  • biomarker
  • cetuximab
  • EGFR inhibitor therapy
  • EGFR ligand
  • metastatic colorectal cancer
  • panitumumab

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