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World J Clin Oncol. Oct 10, 2015; 6(5): 133-141
Published online Oct 10, 2015. doi: 10.5306/wjco.v6.i5.133
Colon cancer and the epidermal growth factor receptor: Current treatment paradigms, the importance of diet, and the role of chemoprevention
Baldeep Pabla, Marc Bissonnette, Vani J Konda
Baldeep Pabla, Marc Bissonnette, Vani J Konda, Center of Endoscopic Research and Therapeutics, Section of Gastroenterology, Department of Medicine, Knapp Center for Biomedical Discovery, the University of Chicago Medicine, Chicago, IL 60637, United States
Author contributions: Konda VJ, Bissonnette M and Pabla B designed research; Pabla B performed research and analyzed data; Konda VJ, Bissonnette M and Pabla B wrote the paper.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Vani J Konda, Center of Endoscopic Research and Therapeutics, Section of Gastroenterology, Department of Medicine, Knapp Center for Biomedical Discovery, the University of Chicago Medicine, 900 E. 57th Street, Room #9134, Chicago, IL 60637, United States. vkonda@medicine.bsd.uchicago.edu
Telephone: +1-773-7021460 Fax: +1-773-7025790
Received: May 4, 2015
Peer-review started: May 5, 2015
First decision: June 3, 2015
Revised: June 8, 2015
Accepted: July 21, 2015
Article in press: July 23, 2015
Published online: October 10, 2015
Processing time: 162 Days and 4.7 Hours
Abstract

Colorectal cancer represents the third most common and the second deadliest type of cancer for both men and women in the United States claiming over 50000 lives in 2014. The 5-year survival rate for patients diagnosed with metastatic colon and rectal cancer is < 15%. Early detection and more effective treatments are urgently needed to reduce morbidity and mortality of patients afflicted with this disease. Here we will review the risk factors and current treatment paradigms for colorectal cancer, with an emphasis on the role of chemoprevention as they relate to epidermal growth factor receptor (EGFR) blockade. We will discuss how various EGFR ligands are upregulated in the presence of Western diets high in saturated and N-6 polyunsaturated fats. We will also outline the various mechanisms of EGFR inhibition that are induced by naturally occurring chemopreventative agents such as ginseng, green tea, and curcumin. Finally, we will discuss the current role of targeted chemotherapy in colon cancer and outline the limitations of our current treatment options, describing mechanisms of resistance and escape.

Keywords: Chemoprevention; Colon cancer; Epidermal growth factor receptor; Western diet; Curcumin; Green tea; Ginseng

Core tip: This review article will summarize the risk factors and current treatment paradigms for colorectal cancer, with an emphasis on the role of targeted chemotherapy and chemoprevention as they relate to epidermal growth factor receptor (EGFR) blockade. It will include an overview of the structure and function of EGFR as well as intracellular pathways regulated by its activity. It will discuss how various EGFR ligands are upregulated in the presence of Western diets that are high in saturated and N-6 unsaturated fat, and will outline the various mechanisms of EGFR inhibition observed with several naturally occurring chemopreventative agents including ginseng, green tea, and curcumin.