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KRAS mutation in lung metastases from colorectal cancer: Prognostic implications
International Conference on Clinical Chemistry & Laboratory Medicine
October 17-18, 2016 Chicago, USA
Michele Ghidini
Humanitas Research Hospital, Italy
Azienda Istituti Ospitalieri di Cremona, Italy
Posters & Accepted Abstracts: Biochem Anal Biochem
Abstract:
Background: KRAS mutant colorectal cancer (CRC) patients develop lung and brain metastases more frequently than KRAS wildtype (WT) counterpart. Methods: We retrospectively investigated the prognostic role of KRAS, BRAF, PIK3CA (exon 20) mutations and loss of PTen in surgically resected lung metastases. Lung specimens from 75 metastatic CRC (mCRC) patients treated with one or more metastasectomies were analyzed. Results: 64% of patients had KRAS WT lung metastases. PTen loss-of- function was found in 75%. BRAF and PIK3CA exon 20 mutations were not found. Seven patients developed brain metastases and 43% of them had KRAS mutation. In univariate analysis, median overall survival (OS) for KRAS WT patients was longer compared to KRAS mutant patients (median 60.9 vs. 36.6 months, P=0.035). In addition, both progression-free survival (PFS) and lung disease-free survival (LDFS) between lung surgery and relapse were not associated with KRAS and PTen status. In multivariate analysis, the risk of death was significantly increased by KRAS mutational status (OS Hazard ratio (HR) 2.17, 95% IC 1.19-3.96, P=0.012) and lack of adjuvant chemotherapy (OS HR 0.10, 95% IC 0.01-0.74, P=0.024). The proportion of KRAS mutations in lung metastases was similar to the expected proportion in primary tumors. Conclusion: Patients harboring KRAS mutation had a poorer survival rate compared to WT group. Moreover, administration of adjuvant chemotherapy after lung metastasectomy (LM) significantly improved both PFS and OS. KRAS mutation is a negative prognostic factor in mCRC patients undergoing LM. Further studies are necessary to confirm these findings.
Biography :
Email: mghido@hotmail.it