Impact of circulating tumor DNA mutant allele fraction on prognosis in RAS -mutant metastatic colorectal cancer
Elez, Elena (Vall d'Hebron Institut d'Oncologia)
Chianese, Chiara (Vall d'Hebron Institut d'Oncologia)
Sanz-García, Enrique (Vall d'Hebron Institut d'Oncologia)
Martinelli, Erica (Università della Campania 'L. Vanvitelli')
Noguerido, Alba (Vall d'Hebron Institut d'Oncologia)
Mancuso, Francesco M. (Vall d'Hebron Institut d'Oncologia)
Caratù, Ginevra (Vall d'Hebron Institut d'Oncologia)
Matito, Judit (Vall d'Hebron Institut d'Oncologia)
Grasselli, Julieta (Vall d'Hebron Institut d'Oncologia)
Cardone, Claudia (Università della Campania 'L. Vanvitelli')
Esposito Abate, Riziero (Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS)
Martini, Giulia
Santos Vivas, Cristina (Universitat de Barcelona)
Macarulla Mercadé, Teresa (Vall d'Hebron Institut d'Oncologia)
Argilés Martínez, Guillem (Vall d'Hebron Institut d'Oncologia)
Garcia, Ariadna (Vall d'Hebron Institut d'Oncologia)
Mulet, Nuria (Universitat de Barcelona)
Maiello, Evaristo (IRCCS Casa Sollievo della Sofferenza)
Normanno, Nicola (Istituto Nazionale Tumori 'Fondazione Giovanni Pascale' IRCCS)
Jones, Frederick (Sysmex Inostics)
Tabernero, Josep (Vall d'Hebron Institut d'Oncologia)
Ciardello, Fortunato (Università della Campania 'L. Vanvitelli')
Salazar, Ramon (Universitat de Barcelona)
Vivancos, Ana (Vall d'Hebron Institut d'Oncologia)
Universitat Autònoma de Barcelona

Fecha:	2019
Resumen:	Despite major advances in the treatment of metastatic colorectal cancer (mCRC), the survival rate remains very poor. This study aims at exploring the prognostic value of RAS -mutant allele fraction (MAF) in plasma in mCRC. Forty-seven plasma samples from 37 RAS -mutated patients with nonresectable metastases were tested for RAS in circulating tumor DNA using BEAMing before first- and/or second-line treatment. RAS MAF was correlated with several clinical parameters (number of metastatic sites, hepatic volume, carcinoembryonic antigen, CA19-9 levels, primary site location, and treatment line) and clinical outcome [progression-free survival (PFS) and overall survival (OS)]. An independent cohort of 32 patients from the CAPRI-GOIM trial was assessed for clinical outcome based on plasma baseline MAF. RAS MAF analysis at baseline revealed a significant correlation with longer OS [Hazard ratios (HR) = 3. 514; P = 0. 00066]. Patients with lower MAF also showed a tendency to longer PFS, although not statistically significant. Multivariate analysis showed RAS MAFs as an independent prognostic factor in both OS (HR = 2. 73; P = 0. 006) and first-line PFS (HR = 3. 74; P = 0. 049). Tumor response to treatment in patients with higher MAF was progression disease (P = 0. 007). Patients with low MAFs at baseline in the CAPRI-GOIM group also showed better OS [HR = 3. 84; 95% confidence intervals (CI) 1. 5-9. 6; P = 0. 004] and better PFS (HR = 2. 5; 95% CI: 1. 07-5. 62; P = 0. 033). This minimally invasive test may help in adding an independent factor to better estimate outcomes before initiating treatment. Further prospective studies using MAF as a stratification factor could further validate its utility in clinical practice.
Ayudas:	Instituto de Salud Carlos III PI12-01589
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Circulating tumor DNA ; MAF ; Metastatic colorectal cancer ; Prognostic biomarker ; RAS analysis
Publicado en:	Molecular Oncology, Vol. 13 (july 2019) , p. 1827-1835, ISSN 1878-0261

DOI: 10.1002/1878-0261.12547
PMID: 31322322

9 p, 351.5 KB

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