Biomarcer-2 :Biomarker informed optimal management of advanced RAS wild type colorectal cancer

This study aims to determine whether patients with a high level of Amphiregulin/epiregulin (AREG/EREG) cancer cell markers for advanced stage colorectal cancer have a better treatment response to a combined chemo- and biological regime. Who is it for? You may be eligible for this study if you are aged 18 years or older, you have been diagnosed with right-sided RAS/BRAF wild type advanced stage colorectal cancer that has not been responsive to an initial treatment regime and you have previously provided a tumour sample for testing. Study details All participants who meet the inclusion criteria will firstly have their previously collected tumour sample tested to determine the level of AREG/EREG cancer cell markers present. Participants who have a high level of AREG and/or EREG cell markers will then begin a treatment regime that combines chemotherapy- irinotecan and biological therapy cetuximab. Treatment will occur every 14 days, in either of two ways- Intravenous infusion on Day 1, or intravenous infusion on Day 1 accompanied by 48 hr infusion pump. The treatment will be at physician discretion. The treatment will continue until disease progression, unacceptable toxicity or withdrawal of participant consent. Participants will be followed up for 3 years after beginning the treatment, unless they choose to withdraw from the study prior to that time. Participants who have a low level of AREG and EREG cell markers will be considered ineligible for participation in this study. It is hoped this research will determine whether the combination of cetuximab and irinotecan based treatment is effective for patients with a high level of AREG/EREG cancer cell markers of advanced stage colorectal cancer. If this treatment is found to be effective for participants with a high level of these markers, this method of screening colorectal patients may then be used more frequently to better prescribe treatments to specific patients.