Colorectal cancer ranks the second lethal cancer and third prevalent malignant tumour worldwide, Despite of different odern modalities for diagnosis,large number of cases diagnosed at metastatic advanced stage .

New treatment approach has been discovered habe been discovered making a huge revolution in metastatic colorectal cancer represented by targeted therapy including anti_EGFR ,anti_angiogenic and kinase inhibitors .

Retrospective study aims to evaluate the effect of EGFR expression in metastatic colorectal cancer and the outcome of treatment with anti_EGFR targeted therapy between left colon and rectal cancer

Inclusion Criteria:

1. age above 18
2. Both sex
3. Performance status zero to one according to ECOG scale system
4. Histo-pathologial diagnosis adenocarcinoma of left colon or rectum.
5. Patients diagnosed with left colon and rectal cancer.
6. Patients eligible to receive chemotherapy (with renal and liver chemistry, and normal CBC.
7. Patients diagnosed with metastatic stage.
8. K-RAS wild type.

Exclusion Criteria:

1. Second malignancy
2. Histo-pathological types other than adenocarcinoma.
3. Right colon cancer patients.
4. Patients refused receiving anti_EGFR targeted therapy.
5. Patients with any abnormalities preventing to receive chemotherapy.
6. Early stages of colorectal cancer.
7. K-RAS mutant type.

Patients with left colon and rectum cancer of stage four received target therapy anti_EGFR targeted therapy