Impact of circulating tumor DNA mutant allele fraction on prognosis in RAS-mutant metastatic colorectal cancer

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 met...

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Detalles Bibliográficos
Autores: Elez, Elena, Chianese, Chiara, Sanz-García, Enrique, Martinelli, Erica, Noguerido, Alba, Mancuso, Francesco Mattia, Caratu, Ginevra, Matito, Judit, Grasselli, Julieta, Cardone, Claudia, Esposito, Riziero Esposito, Martini, Giulia, Santos, Cristina, Macarulla, Teresa, Argilés, Guillem, Capdevila, Jaume, Garcia, Ariadna, Mulet Margalef, Núria, Maiello, Evaristo, Normanno, Nicola, Jones, Frederick, Tabernero Caturla, Josep, Ciardello, Fortunato, Salazar Soler, Ramón, Vivancos, Ana
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/177745
Acceso en línea:https://hdl.handle.net/2445/177745
Access Level:acceso abierto
Palabra clave:Sang
Genètica
Càncer colorectal
Mortalitat
Mutació (Biologia)
Blood
Genetics
Colorectal cancer
Mortality
Mutation (Biology)
Descripción
Sumario: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.

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