P-163 - Is KRAS status prognostic or predictive for anti-EGFR treatment with erlotinib in patients with advanced pancreatic cancer?

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
Pancreatic Cancer
Translational Research
Presenter H. Satake
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors H. Satake, A. Tsuji, Y. Imai, T. Kotake, Y. Okita, Y. Hatachi
  • Kobe City Medical Center General Hospital, Kobe/JP

Abstract

Introduction

Erlotinib plus gemcitabine is a standard chemotherapy for unresectable pancreatic cancer. Pancreatic cancer has the highest frequency of KRAS gene mutations among human cancers, and some studies suggest that KRAS status might be a prognostic or predictive biomarker for anti-EGFR treatment. However, the reliability this biomarker has not been confirmed. Here, we evaluated the impact of KRAS mutations in pancreatic cancer patients treated with 1st line gemcitabine–based chemotherapy.

Methods

From January 2011 to December 2012, 23 consecutive patients with unresectable pancreatic cancer treated with gemcitabine-based chemotherapy whose KRAS status could be examined from primary or metastatic lesions were enrolled. KRAS mutations were analyzed by sequencing codons 12 and 13. We retrospectively evaluate the correlation between KRAS status, and prognosis and treatment efficacy.

Results

Patient characteristics were as follows: median age 68 years, male/female = 6/17, PS 0/1 = 9/14, TNM stage III/IV = 1/22, and gemcitabine alone/erlotinib plus gemcitabine = 13/10. Among the 23 patients, KRAS codon 12 was mutated in 15, one of whom also had mutation on codon 13. Median progression-free survival (PFS) and overall survival (OS) of all patients were 4.3 months (95% confidence interval (CI): 3.1 to 5.4) and 8.1 months (95% CI: 5.9 to 10.0; events in 96%), respectively. KRAS status showed no association with PFS (p = 0.310), OS (p = 0.934), or the efficacy of treatment with (p = 0.833) or without erlotinib (p = 0.478).

Conclusion

In this study, there was no correlation between KRAS status and the efficacy of 1st line chemotherapy with gemcitabine with or without erlotinib. Identification of a rationale for personalized medicine in pancreatic cancer will require further exploratory prospective studies.