Role of Kras Status in Patients with Metastatic Colorectal Cancer Receiving First-Line Chemotherapy plus Bevacizumab: A TTD Group Cooperative Study

Background: In the MACRO study, patients with metastatic colorectal cancer (mCRC) were randomised to first-line treatment with 6 cycles of capecitabine and oxaliplatin (XELOX) plus bevacizumab followed by either single-agent bevacizumab or XELOX plus bevacizumab until disease progression. An additio...

Descripción completa

Detalles Bibliográficos
Autores: Diaz-Rubio, Eduardo, Gomez-Espana, Auxiliadora, Massuti, Bartomeu, Sastre, Javier, Reboredo, Margarita, Luis Manzano, Jose, Rivera, Fernando, Jose Safont, Ma, Montagut, Clara, Gonzalez, Encarnacion, Benavides, Manuel, Marcuello, Eugenio, Cervantes, Andres, Martinez de Prado, Purificacion, Fernandez-Martos, Carlos, Arrivi, Antonio, Bando, Inmaculada, Aranda, Enrique, Spanish Cooperative Grp Treatment
Tipo de recurso: artículo
Fecha de publicación:2012
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/16596
Acceso en línea:https://hdl.handle.net/20.500.13003/16596
Access Level:acceso abierto
Palabra clave:Humans
Aged, 80 and over
Aged
Adult
Antibodies, Monoclonal, Humanized
Deoxycytidine
Genes, ras
Organoplatinum Compounds
Antineoplastic Combined Chemotherapy Protocols
Middle Aged
Prognosis
Male
Fluorouracil
Mutation
Neoplasm Metastasis
Female
Colorectal Neoplasms
Bevacizumab
Capecitabine
Neoplasias Colorrectales
Mutación
Masculino
Compuestos Organoplatinos
Protocolos de Quimioterapia Combinada Antineoplásica
Desoxicitidina
Humanos
Pronóstico
Anciano
Anciano de 80 o más Años
Adulto
Persona de Mediana Edad
Femenino
Anticuerpos Monoclonales Humanizados
Metástasis de la Neoplasia
Capecitabina
Fluorouracilo
Genes ras
Descripción
Sumario:Background: In the MACRO study, patients with metastatic colorectal cancer (mCRC) were randomised to first-line treatment with 6 cycles of capecitabine and oxaliplatin (XELOX) plus bevacizumab followed by either single-agent bevacizumab or XELOX plus bevacizumab until disease progression. An additional retrospective analysis was performed to define the prognostic value of tumour KRAS status on progression-free survival (PFS), overall survival (OS) and response rates. Methodology/Principal Findings: KRAS data (tumour KRAS status and type of mutation) were collected by questionnaire from participating centres that performed KRAS analyses. These data were then cross-referenced with efficacy data for relevant patients in the MACRO study database. KRAS status was analysed in 394 of the 480 patients (82.1%) in the MACRO study. Wild-type (WT) KRAS tumours were found in 219 patients (56%) and mutant (MT) KRAS in 175 patients (44%). Median PFS was 10.9 months for patients with WT KRAS and 9.4 months for patients with MT KRAS tumours (p = 0.0038; HR: 1.40; 95% CI: 1.12-1.77). The difference in OS was also significant: 26.7 months versus 18.0 months for WT versus MT KRAS, respectively (p = 0.0002; HR: 1.55; 95% CI: 1.23-1.96). Univariate and multivariate analyses showed that KRAS was an independent variable for both PFS and OS. Responses were observed in 126 patients (57.5%) with WT KRAS tumours and 76 patients (43.4%) with MT KRAS tumours (p = 0.0054; OR: 1.77; 95% CI: 1.18-2.64). Conclusions/Significance: This analysis of the MACRO study suggests a prognostic role for tumour KRAS status in patients with mCRC treated with XELOX plus bevacizumab. For both PFS and OS, KRAS status was an independent factor in univariate and multivariate analyses.

Similares en LA Referencia