Fig. 3

Strategies to increase anti-EGFR therapy efficiency in different subtypes of mCRC. Biomarker analysis should be conducted before treatment for mCRC. For patients with disease progression on anti-EGFR therapy, biomarker analysis is still recommended. For mCRC with driver gene alterations, there are some therapies to increase anti-EGFR efficiency. In RAS-mut mCRC, the selected therapies include a combination of RAS inhibitors and anti-EGFR agents, metabolic regulators, immune therapy, cytotoxic drugs and natural bioactive monomers. In RAF-mut mCRC, the main therapy is a BRAF inhibitor. In ERBB2-amp mCRC, ERBB2 inhibitors can be used to promote the antiproliferation of anti-EGFR. In MET-amp mCRC, combined therapy with MET inhibitors and anti-EGFR mAbs was confirmed to be effective. In mCRC with EGFR ECD-mut, new anti-EGFR agents are preferred. In mCRC with no driver gene alteration, multitargeted therapies, metabolic regulators, immune therapy, cytotoxic drugs and antiangiogenic agents can be used with anti-EGFR. Abbreviations: mCRC, metastatic colorectal cancer; EGFR, epidermal growth factor receptor; ERBB2, human epidermal growth factor receptor 2; MET, tyrosine-protein kinase Met; MSI-H, microsatellite instability; dMMR, dysfunctional mismatch repair; PD-1/PD-L1, programmed death-1/programmed death ligand 1; ECD, extracellular domain; WT, wild type; mut, mutation