Single Nucleotide Polymorphism(SNP)Study

Patient Population:

150 Patients with histologically proven stage IV (AJCC 7th Edition) colorectal cancer (CRC) expressing wild-type KRAS or stage IV non-small cell lung cancer (NSCLC) expressing EGFR (tested by immunohistochemistry (IHC)), with no previous exposure to Cetuximab or Panitumumab, who will receive treatment with an EGFR-antibody (Cetuximab or Panitumumab).

Inclusion Criteria:

1. Stage IV (AJCC 7th Edition TMN Staging, Appendix C), histologically confirmed CRC with wild-type KRAS and not a candidate for metastectomy.
2. Stage IV (AJCC 7th Edition, TMN Staging, Appendix C) NSCLC expressing EGFR (IHC tested)
3. Patients, who will receive treatment with an EGFR-antibody (Cetuximab or Panitumumab).
4. Karnofsky performance status (Appendix B) score ≥60.

5. Acceptable laboratory values:

   • Haemoglobin ≥ 9 g/dL.
   • Neutrophil count ≥ 1.0 x 10^9/L.
   • Platelet count ≥100 x 10^9/L.
   • Serum creatinine ≤1.5 times the upper limit of normal.
   • Bilirubin ≤1.5 times the upper limit of normal.
   • Aspartate aminotransferase and alanine aminotransferase ≤5 times the upper limit of normal.
6. Must have at least 1 unidimensional measurable lesion

Exclusion Criteria:

1. Aged < 18 years
2. Prior exposure to Cetuximab or Panitumumab
3. The CRC does not carry wild-type KRAS.
4. The NSCLC stains negative for EGFR protein expression
5. Second cancer diagnosis (apart from non-melanoma skin cancer)
6. Known hypersensitivity to Cetuximab or Panitumumab, or murine protein.
7. Known history of coronary artery disease, arrhythmias, or congestive heart failure (If the treating physician feels that a patient's coronary artery disease / arrhythmia / congestive heart failure does not place him/her at risk from treatment with an anti-EGFR antibody, the person can be included. This is a clinical decision, which has to be made by the treating physician).
8. Known to be pregnant (pregnancy test is not mandatory) or breast-feeding.