A 61-Year-Old Man Comes to the Office Due to 4

question 672

Multiple Choice

A 61-year-old man comes to the office due to 4 months of easy fatigability, anorexia, and a 4.5-kg (10-lb) unintentional weight loss.  His stool occult blood testing is positive, and laboratory studies show microcytic hypochromic anemia.  Colonoscopy reveals a 6-cm (2.4-in) mass in the descending colon.  Biopsy samples obtained during the procedure are consistent with adenocarcinoma.  A subsequent CT scan of the abdomen shows multiple metastatic liver lesions.  Therapy with monoclonal antibodies that bind to epidermal growth factor receptors on the malignant cells is considered.  An activating mutation in which of the following will most likely make this therapy ineffective?

• A)Adenomatous polyposis coli protein
• B)KRAS protein
• C)p53 protein
• D)Platelet-derived growth factor
• E)Vascular endothelial growth factor

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