Primary tumor location predicts poor clinical outcome with cetuximab in RAS wild-type metastatic colorectal cancer

BMC Gastroenterology

Research Article

Ji Sung Lee¹  Young-Kwang Yoon¹  Sun Young Kim²  Yong Sang Hong²  Jeong Eun Kim²  Kyu-pyo Kim²  Tae Won Kim³  Dalyong Kim⁴  Jihun Kim⁵  Se Jin Jang⁵ 

[1] Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea;Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Republic of Korea;Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Republic of Korea;Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea;Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Republic of Korea;Department of Hematology/Oncology, Yuseong Sun Hospital, 93, Bugyuseong-daero, Yuseong-gu, 34084, Daejeon, South Korea;Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea;

关键词: Primary tumor location;    Metastatic colorectal cancer;    Cetuximab;    RAS;    EGFR;   

DOI  :  10.1186/s12876-017-0694-6

 received in 2016-12-06, accepted in 2017-11-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn metastatic colorectal cancer, the location of the primary tumor has been suggested to have biological significance. In this study, we investigated whether primary tumor location affects cetuximab efficacy in patients with RAS wild-type metastatic colorectal cancer.MethodsGenotyping by the SequenomMassARRAY technology platform (OncoMap) targeting KRAS, NRAS, PIK3CA, and BRAF was performed in tumors from 307 patients who had been given cetuximab as salvage treatment. Tumors with mutated RAS (KRAS or NRAS; n = 127) and those with multiple primary location (n = 10) were excluded. Right colon cancer was defined as a tumor located in the proximal part to splenic flexure.ResultsA total of 170 patients were included in the study (right versus left, 23 and 147, respectively). Patients with right colon cancer showed more mutated BRAF (39.1% vs. 5.4%), mutated PIK3CA (13% vs. 1.4%), poorly differentiated tumor (17.4% vs. 3.4%), and peritoneal involvement (26.1% vs. 8.8%) than those with left colon and rectal cancer. Right colon cancer showed poorer progression-free survival (2.0 vs.5.0 months, P = 0.002) and overall survival (4.1 months and 13.0 months, P < 0.001) than the left colon and rectal cancer. By multivariable analysis, BRAF mutation, right colon primary, poorly differentiated histology, and peritoneal involvement were associated with risk of death.ConclusionsIn RAS wild-type colon cancer treated with cetuximab as salvage treatment, right colon primary was associated with poorer survival outcomes than left colon and rectal cancer.

【 授权许可】

CC BY   
© The Author(s). 2017