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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4986 - KRAS mutations as a prognostic factor after metastasectomy in colorectal cancer patients

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Targeted Therapy

Tumour Site

Colon and Rectal Cancer

Presenters

Marta Domenech Viñolas

Citation

Annals of Oncology (2018) 29 (suppl_8): viii150-viii204. 10.1093/annonc/mdy281

Authors

M. Domenech Viñolas1, C. Santos1, J. Pérez2, M. Varela3, M. Martinez Villacampa1, A. Teule1, J.C. Ruffinelli Rodriguez1, N. Mulet Margalef1, G. Soler1, A. Ortega1, M.S. Bergamino1, X. SanJuan3, J. Torras4, E. Ramos4, R. Salazar1

Author affiliations

  • 1 Medical Oncology, Catalan Institute of Oncology, 08908 - Hospitalet de Llobregat/ES
  • 2 Research Unit, Catalan Institute of Oncology, 08908 - Hospitalet de Llobregat/ES
  • 3 Pathology, Hospital Universitari de Bellvitge, 08908 - Hospitalet de Llobregat/ES
  • 4 Surgical, Hospital Universitari de Bellvitge, 08908 - Hospitalet de Llobregat/ES
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Resources

Abstract 4986

Background

Different clinicopathological factors have been associated with survival after liver metastasis resection in metastatic colorectal cancer (mCRC) patients. However, there is a need to better identify those patients who may benefit from metastasis resection. In this retrospective study we aimed to analyse clinical outcomes according to KRAS mutational status in a prospective collected series of mCRC patients.

Methods

We evaluated mCRC patients with exon 2 KRAS mutational status assessed between 2010 and 2014. Exon 2 KRAS mutational analysis was performed by therascreen® or cobas® assays. We excluded patients (pts) with no clinical data available. Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan-Meier method.

Results

KRAS mutational status was assessed in 395 mCRC patients, but clinical data were only available in 348 patients. Median age was 66 years old. Two hundred and twenty-six patients were male (65%) and 210 pts (60%) had synchronous metastases at diagnosis. KRAS mutations were detected in 175 tumours (51%). Liver was the most common site of metastasis (210 pts, 60%), followed by lung (133 pts, 33%), lymph nodes (56 pts, 16%) and peritoneum (44 pts, 11%). Lung metastases at diagnosis were more frequent in KRAS mutant tumours (38% vs 27%, p-value = 0.022). We observed different metastasis spread pattern between pts with KRAS mutant and KRAS wt tumours. Risk of lung metastasis after 50 months of follow-up was higher in KRAS mutant tumours (77% vs 60%, p=.023). Risk of brain metastasis was also higher (18% vs 2%, p=.012). Median OS was 37 months, with no differences observed between KRAS mutant and KRAS wt tumours (34 vs 41 months, p-value = .70). One hundred thirty-nine patients underwent metastases resection (39.9%). In this subgroup of patients, KRAS mutations were associated with worse DFS (13.3 vs 24.5 months, p-value=.024).

Conclusions

KRAS mutations were associated with lung metastasis in CRC patients and different pattern spread. Although KRAS mutations were not a prognostic biomarker in the metastatic setting, patients with KRAS mutant tumours had a shorter DFS after metastasis resection.

Clinical trial identification

Legal entity responsible for the study

Catalan Institute of Oncology.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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