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Effect of KRAS mutational status on disease behavior and treatment outcome in patients with metastatic colorectal cancer: intratumor heterogeneity and mutational status
Faculty
Medicine
Year:
2019
Type of Publication:
ZU Hosted
Pages:
Authors:
Alaa Abdelhamied Bahgat Fayed
Staff Zu Site
Abstract In Staff Site
Journal:
journal gastrointest oncol journal gastrointest oncol
Volume:
Keywords :
Effect , KRAS mutational status , disease behavior
Abstract:
Background: Nowadays, the outcomes of metastatic colorectal cancer (mCRC) have considerably improved. Genetic studies evaluating KRAS mutational status are important in the personalized therapy era to understand disease heterogeneity, disease behaviors, and treatment outcomes. Methods: This multicenter retrospective study evaluated 360 patients with mCRC treated at three oncology centers in Saudi Arabia and Egypt between February 2011 and December 2015. Patients were treated with bevacizumab and cetuximab according to guidelines. Therapy outcome, time to progression, and disease-associated death were assessed. KRAS mutational status was evaluated by testing exons 12 and 13. Results: Approximately 220 (61.1%) cases were of wild-type KRAS, whereas KRAS mutation was noted in 38.9%. KRAS mutation was common in the descending colon, whereas a low incidence of the KRAS mutation was observed in the ascending colon (P<0.001). Among patients with KRAS mutation, 64.3% initially presented as emergency cases with obstruction/perforation (P=0.002), and 62.9% had hepatic or pulmonary metastasis. The progression-free survival (PFS) was 10.7 months. Cases without KRAS mutation showed a higher PFS than did those with KRAS mutation (mean PFS: 11.5 vs. 9.6 months, P=0.001). The overall survival was 23.2 months. The survival varied considerably according to KRAS type: patients without mutation survived for 25.0 months and those with mutation survived for 19.6 months (P<0.001). Disease related death occurred in 132 (36.7%) cases, approximately 57.1% of them (80 cases) had KRAS mutation (P=0.001). Conclusions: A major association between KRAS mutational status and both disease behavior and treatment outcomes was found in this study. Patients with KRAS mutation show advanced disease presentation, with lower PFS and overall survival.
Author Related Publications
Alaa Abdelhamied Bahgat Fayed, "COMPARISON OF HIGH-DOSE-RATE AND LOW-DOSE-RATE BRACHYTHERAPY IN THE TREATMENT OF ENDOMETRIAL CARCINOMA", Elsevier, 2007
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Alaa Abdelhamied Bahgat Fayed, "Percutaneous local injection of combined ethanol and mitoxantron versus radiofrequency ablation in treatment of Hepatocellular Carcinoma.", marsland press, 2015
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Alaa Abdelhamied Bahgat Fayed, "Evaluation of Different Radiotherapy Schedules In Brain Metastases", marsland press, 2013
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Alaa Abdelhamied Bahgat Fayed, "Addition of Daily Synchronous 3-Dimensional Conformal Boost to Gross Tumor Volume in Concurrent Chemoradiation plus Adjuvant Chemotherapy in Locally Advanced Nasopharyngeal Carcinoma", marsland press, 2015
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Alaa Abdelhamied Bahgat Fayed, "Correlations between P53 mutations and response to Paclitaxel/Cisplatin Chemotherapy in Patients with Advanced Epithelial Ovarian Cancer", marsland press, 2015
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Department Related Publications
Walid Elsayed Hamouda, "تقييم دور العلاج الكيماوي والاشعاعي قبل الجراحه في حالات السرطان المستقيم المستشري موضوعيا", لايوجد, 1900
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Walid Elsayed Hamouda, "مقارنةالعلاج الاشعاعى مع التمودال بالعلاج الاشعاعى المنفرد فى حالات اورام المخ من الدرجة الثالثة والرابعة", مجلة جامعة الزقازيق الطبية, 2006
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Walid Elsayed Hamouda, "مقارنةالعلاج الاشعاعى مع التمودال بالعلاج الاشعاعى المنفرد فى حالات اورام المخ من الدرجة الثالثة والرابعة", جامعه الزقازيق الطبيه, 2001
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Walid Elsayed Hamouda, "تقييم دور العلاج الكيماوى والاشعاعى قبل الجراحة فى حالات سرطان المستقيم المستشرى موضعيا", مجلة جامعة الزقازيق الطبية, 2006
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Reham Safwat Elsayed Fahmy, "دراسه مقارنه بين حقن عقار السيبسلاتين اسبوعيا ملازما للعلاج الاشعاعى فقط في حالات سرطان عنق الرحم المتقدم", مجله جامعه الزقازيق الطبيه, 2001
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