Br J Cancer: Effects of BRAF, KRAS and MSI on cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with metastatic colorectal cancer (mCRC) with peritoneal metastasis (PM)

Metastatic with BRAF (mutBRAF) or KRAS mutation (mutKRAS)Colorectal cancer (mCRC) patients have poor prognosis after liver or lung surgery, while the prognostic role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastases (PM) is unclear
.

Therefore, a team from Norway carried out a related study, and the relevant results were published in the British Journal of Cancer

Metastatic with BRAF (mutBRAF) or KRAS mutation (mutKRAS)Colorectal cancer (mCRC) patients have poor prognosis after liver or lung surgery, while the prognostic role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastases (PM) is unclear

The study included 257 patients, of whom 180 received CRS-HIPEC and 77 received only palliative surgery
.

Among the 174 patients who underwent molecular testing of CRS-HIPEC, mutKRAS (n=59, 33.

The study included 257 patients, of whom 180 received CRS-HIPEC and 77 received only palliative surgery

The median survival time after CRS-HIPEC was 49 months, compared with 15 months in the palliative care group (P<0.
001), and the 5-year survival rate was 40.
1% vs 3.
8%
.

The median DFS after CRS-HIPEC was 11 months

The median survival time after CRS-HIPEC was 49 months, compared with 15 months in the palliative care group (P<0.

There were no significant differences in OS and DFS after CRS-HIPEC when stratified for mutKRAS, mutBRAF or dual wt
.

However, CRS-HIPEC patients with mutBRAF and MSS had a shorter median OS (42 months) than mutBRAF and MSI patients, corresponding to a 5-year OS rate of 25.

There were no significant differences in OS and DFS after CRS-HIPEC when stratified for mutKRAS, mutBRAF or dual wt

There was no correlation between mutation status and type of recurrence
.

In multivariate analysis, PCI (peritoneal tumor index, HR 1.

There was no correlation between mutation status and type of recurrence

In conclusion, the study showed that the proportion of mutBRAF in PM-CRC patients undergoing CRS-HIPEC was higher (24.
7%)
.

Survival was similar in patients with mutBRAF, mutKRAS, and double wild-type, whereas survival was better in patients with mutBRAF and MSI
.
CRS-HIPEC should be considered for patients with mutBRAF tumors and localized PM
.

In conclusion, the study showed that the proportion of mutBRAF in PM-CRC patients undergoing CRS-HIPEC was higher (24.
7%)
.
Survival was similar in patients with mutBRAF, mutKRAS, and double wild-type, whereas survival was better in patients with mutBRAF and MSI
.
CRS-HIPEC should be considered for patients with mutBRAF tumors and localized PM
.
The study showed that the proportion of mutBRAF in PM-CRC patients undergoing CRS-HIPEC was higher (24.
7%)
.
Survival was similar in patients with mutBRAF, mutKRAS, and double wild-type, whereas survival was better in patients with mutBRAF and MSI
.
CRS-HIPEC should be considered for patients with mutBRAF tumors and localized PM
.
The study showed that the proportion of mutBRAF in PM-CRC patients undergoing CRS-HIPEC was higher (24.
7%)
.
Survival was similar in patients with mutBRAF, mutKRAS, and double wild-type, whereas survival was better in patients with mutBRAF and MSI
.
CRS-HIPEC should be considered for patients with mutBRAF tumors and localized PM
.

Original source:

Original source:

Larsen SG, Goscinski MA, Dueland S, Steigen SE, Hofsli E, Torgunrud A, Lund-Iversen M, Dagenborg VJ, Flatmark K, Sorbye H.
Impact of KRAS, BRAF and microsatellite instability status after cytoreductive surgery and HIPEC in a national cohort of colorectal peritoneal metastasis patients.
Br J Cancer.
2022 Mar;126(5):726-735.
doi: 10.
1038/s41416-021-01620-6.
Epub 2021 Dec 9.
PMID: 34887523; PMCID: PMC8888568.

Larsen SG, Goscinski MA, Dueland S, Steigen SE, Hofsli E, Torgunrud A, Lund-Iversen M, Dagenborg VJ, Flatmark K, Sorbye H.
Impact of KRAS, BRAF and microsatellite instability status after cytoreductive surgery and HIPEC in a national cohort of colorectal peritoneal metastasis patients.
Br J Cancer.
2022 Mar;126(5):726-735.
doi: 10.
1038/s41416-021-01620-6.
Epub 2021 Dec 9.
PMID: 34887523; PMCID: PMC8888568 .