Abstract 3364
Background
RAS mutational status is an essential criterion to guide first-line treatment in metastatic colorectal cancer (mCRC). MORE-RAS was a multicenter, multicountry, observational, ambispective (retrospective + prospective) study conducted in the Middle East and North Africa (MENA) region to assess RAS testing practices and tumor characteristics in newly diagnosed patients (pts) with mCRC. Results of the retrospective analysis are presented here.
Methods
Eligible pts included adults aged ≥18 with mCRC who had already initiated first-line therapy, had at least 1 post-baseline visit for disease evaluation, and had available survival data. Pts with incomplete and unavailable data or presence of other coexisting malignancies were excluded. Data from eligible pts were retrospectively analysed 2 years back from the day of patient consent.
Results
A total of 495 pts (median age: 57 y) were enrolled; majority were male (55.6%), with adenocarcinoma histology, stage IV disease (86.8%) and left-sided tumors (79%). Primary tumor site was sigmoid (40.9%), followed by rectal (26.1%), ascending (17.2%), descending (12.1%), and transverse (3.8%) colon. RAS testing was requested in 417 (78%) pts; reasons for not prescribing included test unavailability, financial/medical decision, or other. Testing samples were mostly paraffin-embedded (91.7%) primary tumors (92.5%); sequencing was the most common test method used. RAS testing found that 33.9% of tumors harbored mutations and 66.1% carried wild-type (WT) sequences. The most common mutation was KRAS (94.1%), occurring largely in Exon2-Codon12 (70.5%). RAS testing was typically prescribed after initiation of first-line treatment, significantly more in pts with stage IV disease (p < 0.005), resulted in addition of targeted therapy (41.8% anti EGFR, 30.2% anti VEGF) in WT mCRC, and significantly impacted treatment strategy of left-sided tumors (p = 0.037).
Conclusions
RAS testing for mCRC in the MENA region was often performed after first-line treatment. The dominance of WT RAS in this region is distinct from the mutational pattern reported in Western countries.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Amgen.
Funding
Amgen.
Disclosure
M. Oukkal: Advisory / Consultancy, Speaker Bureau / Expert testimony: Amgen; Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (self): Roche; Advisory / Consultancy: Novartis; Advisory / Consultancy: Pfizer; Speaker Bureau / Expert testimony: Bayer; Speaker Bureau / Expert testimony: Ipsen. H. Mahfouf: Advisory / Consultancy, Speaker Bureau / Expert testimony: Amgen; Advisory / Consultancy, Speaker Bureau / Expert testimony: Roche; Advisory / Consultancy, Speaker Bureau / Expert testimony: Merck; Advisory / Consultancy, Speaker Bureau / Expert testimony: Bayer; Advisory / Consultancy: Ipsen. A. Ouamer: Full / Part-time employment: Amgen. L. Bashir: Full / Part-time employment: Amgen. All other authors have declared no conflicts of interest.
Resources from the same session
4250 - Phase II study of avelumab in combination with cetuximab as a rechallenge strategy in pre-treated RAS wild type metastatic colorectal cancer patients: CAVE (cetuximab-avelumab) Colon.
Presenter: Erika Martinelli
Session: Poster Display session 2
Resources:
Abstract
5234 - The ORCHESTRA trial; A phase III trial of adding tumor debulking to systemic therapy versus systemic therapy alone in multi-organ metastatic colorectal cancer (mCRC).
Presenter: Lotte Bakkerus
Session: Poster Display session 2
Resources:
Abstract
5294 - EMERGE: Epigenetic Modulation of the Immune Response in Gastrointestinal cancers
Presenter: Elizabeth Cartwright
Session: Poster Display session 2
Resources:
Abstract
913 - Phase III, international, multicenter, randomized, open-label trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P/G) vs gemcitabine (G) alone for surgically resected pancreatic adenocarcinoma (APACT): subgroup analyses
Presenter: Margaret Tempero
Session: Poster Display session 2
Resources:
Abstract
1668 - FOLFIRINOX in locally advanced (LA) and borderline resectable (BR) pancreatic adenocarcinoma : update of the AGEO cohort.
Presenter: Edouard Auclin
Session: Poster Display session 2
Resources:
Abstract
2559 - Impact of adjuvant treatment with nab-paclitaxel and gemcitabine (nab-P+GEM) vs gemcitabine alone (GEM) on health-related quality of life (QoL) in patients (pts) with surgically resected pancreatic adenocarcinoma (PA) in the Adjuvant Pancreatic Adenocarcinoma Clinical Trial (APACT)
Presenter: Hanno Riess
Session: Poster Display session 2
Resources:
Abstract
4897 - Early detection of pancreatic ductal adenocarcinoma using methylation signatures in circulating tumor DNA
Presenter: Xiao-ding Liu
Session: Poster Display session 2
Resources:
Abstract
1755 - Evaluation of minimal important difference (MID) for the European Organisation for Research and Treatment of Cancer (EORTC) Pancreatic Cancer Module (PAN26) in patients with surgically resected pancreatic adenocarcinoma
Presenter: Michele Reni
Session: Poster Display session 2
Resources:
Abstract
2876 - Multispectral analysis of lymphocyte complexity in periampullary adenocarcinoma
Presenter: Sebastian Lundgren
Session: Poster Display session 2
Resources:
Abstract
1902 - Phase II trial of preoperative modified FOLFIRINOX (mFOLFIRINOX) followed by postoperative gemcitabine (GEM) in patients (pts) with borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC)
Presenter: Jae Ho Jeong
Session: Poster Display session 2
Resources:
Abstract