Abstract 96P
Background
Brain metastases (BM) due to colorectal cancer (CRC) are an infrequent event. Previous research suggests that patients with pulmonary metastases, rectal primaries and KRAS mutations are at an increased risk of BM. Despite multidisciplinary treatment, survival following BM remains poor. We aimed to analyse the incidence, genomic profiling, treatment administered and survival in patients with BM from CRC within our cancer service.
Methods
A retrospective analysis of 1346 CRC patients at two comprehensive cancer centres in Western Sydney identified 52 patients with BM. Data was subsequently collected on patient demographics, tumour and treatment characteristics. KRAS and BRAF mutation status from primary colorectal tumour specimens and surgical resection of BM was assessed. Survival data was analysed by the Kaplan-Meier method.
Results
The incidence of BM in our cohort was 3.9%. The mean age of patients was 66 (35-82) with 48% female and 52% male in the BM group compared to 36% female and 64% male in the non-BM group. 33% of patients were wildtype (WT), 62% had a RAS mutation and 5% were BRAF mutant. The median time between diagnosis of primary CRC and development of BM did not differ between RAS, RAF and WT (37, 50 and 43 months). 70% of WT patients presented with one BM compared to 45% of KRAS mutated patients although this was not statistically significant (p = 0.13). 38% of patients had surgery while 81% had radiotherapy (56% WBRT, 44% SRS) to treat their BM. The median PFS across all groups was 3.2 months and median OS was 3.9 months. Median PFS was significantly longer in patients who received surgery, chemotherapy and radiotherapy following their diagnosis of BM (12.3 months) versus surgery alone (1 month) or surgery and radiotherapy (4.4 months) (p = 0.022). Mutational status or number of BM did not impact on PFS or OS. Patients with synchronous liver metastases had a significantly shorter median OS of 3 months versus 13 months in those without liver metastases (p = 0.008).
Conclusions
Brain metastases remains an infrequent event in patients with metastatic colorectal cancer. KRAS and BRAF mutations do not appear to have any effect on prognosis or response to treatment in CRC patients with BM. Survival of CRC patients following BM is poor and novel approaches are needed.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Western Sydney Local Health District.
Disclosure
K.Y.M. Wong: Advisory / Consultancy: Baxalta; Speaker Bureau / Expert testimony: Sirtex; Travel / ccommodation / Expenses: MSD Oncology. All other authors have declared no conflicts of interest.
Resources from the same session
144P - Severe hypovitaminosis D in metastatic gastric cancer patients from the Northern and Southern hemispheres: Data from the EXPAND phase III trial
Presenter: Radka Obermannova
Session: Poster display session
Resources:
Abstract
145P - Role of Glasgow prognostic score in chemo-naïve patients with advanced biliary tract cancer and good performance status
Presenter: Toshikazu Moriwaki
Session: Poster display session
Resources:
Abstract
146P - Anatomic versus non-anatomic resection for hepatocellular carcinoma: A meta-analysis of high-quality studies
Presenter: Bin Zhang
Session: Poster display session
Resources:
Abstract
147P - Clinical outcomes of proximal gastrectomy versus total gastrectomy for locally advanced proximal gastric cancer: a propensity score matching analysis
Presenter: Yingtai Chen
Session: Poster display session
Resources:
Abstract
148P - Efficacy of capecitabine and oxaliplatin versus S-1 as adjuvant chemotherapy in gastric cancer after D2 lymph node dissection according to lymph node ratio and N stage
Presenter: Seunghwan Lee
Session: Poster display session
Resources:
Abstract
150P - A Phase Ib Study of IMU-131 HER2/neu peptide vaccine plus chemotherapy in patients with HER2/neu overexpressing metastatic or advanced adenocarcinoma of the stomach or gastroesophageal junction
Presenter: Yee Chao
Session: Poster display session
Resources:
Abstract
151P - Gene expression profiling for a better understanding of gastric cancer: From the perspective of metabolic rearrangement
Presenter: Midie Xu
Session: Poster display session
Resources:
Abstract
152P - Long-term outcomes of three-dimensional conformal radiotherapy-based and intensity-modulated radiotherapy-based concurrent chemoradiotherapy in patients with thoracic esophageal squamous cell carcinoma
Presenter: Chia-Lun Chang
Session: Poster display session
Resources:
Abstract
153P - Exosomal LINC00174 facilitates epithelial-mesenchymal transition in residual hepatocellular carcinoma after insufficient radiofrequency ablation by regulating c-JUN/MYCBP/c-Myc axis
Presenter: Dening Ma
Session: Poster display session
Resources:
Abstract
154P - Genetic characteristics of participants in the Australian Pancreatic Screening Study
Presenter: Krithika Murali
Session: Poster display session
Resources:
Abstract