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Front Oncol: Comparison of response and prognosis of KRAS G12C mutation and other subtypes in patients with metastatic colorectal cancer (mCRC) using standard first-line treatment

 Last Update: 2021-10-10
 Source: Internet
 Author: User

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Metastatic colorectal cancer (mCRC) with KRAS mutations usually develops primary resistance to anti-EGFR therapy
.

KRAS mutations include multiple subtypes, such as G12C, G12D, G12A, and G12V

Metastatic colorectal cancer (mCRC) with KRAS mutations usually develops primary resistance to anti-EGFR therapy

Patients with KRAS mutant mCRC who received first-line treatment with the FOLFIRI/FOLFOX/ XELOX + Bevacizumab regimen were included in the study
.

Exclude patients who have NRAS mutations or who also express BRAF mutations

Patients with KRAS mutant mCRC who received first-line treatment with the FOLFIRI/FOLFOX/ XELOX + Bevacizumab regimen were included in the study

120 patients were finally included in the study analysis, of which 15 were KRAS G12C mutations (12%), KRAS G12D mutations 48/120 (40%), KRAS G12V mutations 32/120 (27%), and the remaining 25/120 patients KRAS The mutation is different from G12C, G12D, and G12V

KRAS mutation distribution

In the entire cohort, 59/120 (49%) patients achieved partial remission (PR), 42/120 (35%) patients had stable disease (SD), and 19/120 (16%) patients had progressive disease (PD)
.

The median PFS was 9.

In the entire cohort, 59/120 (49%) patients achieved partial remission (PR), 42/120 (35%) patients had stable disease (SD), and 19/120 (16%) patients had progressive disease (PD)

Therapeutic response

Among KRAS G12C mutation patients, 4/15 (27%) were PR, 6/15 (40%) were SD, and the remaining 5/15 (33%) were PD
.

Among other patients with KRAS mutations, 55/105 (52%) had PR, 37/105 (35%) had SD, and the remaining 13/105 (12%) had PD

Among KRAS G12C mutation patients, 4/15 (27%) were PR, 6/15 (40%) were SD, and the remaining 5/15 (33%) were PD

In patients with KRAS G12D mutation, PR was 25/48 (52%), SD was 17/48 (35%), PD was 6/48 (13%), and in KRAS G12V mutation patients, PR It was 15/32 cases (47%), SD was 14/32 cases (44%), and PD was 3/32 cases (9%)

The mPFS of patients in the G12C mutation group was 8.

PFS

After propensity score matching, the response rate (RR) difference between patients with KRAS G12C mutation and other KRAS mutation patients is still statistically significant (p=0.
016), while the median PFS (HR: 1.
24, 95%CI: 0.
58–2.
67) , p=0.
55) and the median OS (HR: 0.
98, 95% 0.
47-2.
08, p=0.
97) are still not statistically different
.

After propensity score matching, the response rate (RR) difference between KRAS G12C mutation patients and other KRAS mutation patients is still statistically significant (p=0.
016), while the median PFS (HR: 1.
24, 95%CI: 0.
58–2.
67) , p=0.
55) and the median OS (HR: 0.
98, 95% 0.
47-2.
08, p=0.
97) are still not statistically different
.

KRAS G12C and other KRAS mutations are also not statistically different in metastasis location (liver metastasis p=1, lung metastasis p=0.
56, peritoneal metastasis p=0.
51), gender (p=0.
06) and ECOG PS (p=0.
21)
.
On the other hand, compared with other KRAS mutations, simultaneous metastasis (p=0.
039), age >75 years (p=0.
043) and mucus histology (p=0.
008) are more common in G12C mutant tumors
.

In summary, among patients with first-line standard treatment for mCRC, patients with KRAS G12C mutations have a lower response rate compared with other mutation subtypes, but there is no statistical difference in median PFS and OS
.
Among patients with first-line standard treatment of mCRC, patients with KRAS G12C mutation had a lower response rate compared with other mutation subtypes, and there was no statistical difference in median PFS and OS
.
Among patients with first-line standard treatment of mCRC, patients with KRAS G12C mutation had a lower response rate compared with other mutation subtypes, and there was no statistical difference in median PFS and OS
.

Original source:

Giampieri R, Lupi A, Ziranu P, Bittoni A, Pretta A, Pecci F, Persano M, Giglio E, Copparoni C, Crocetti S, Mandolesi A, Faa G, Coni P, Scartozzi M and Berardi R (2021) Retrospective Comparative Analysis of KRAS G12C vs.
Other KRAS Mutations in mCRC Patients Treated With First-Line Chemotherapy Doublet + Bevacizumab.
Front.
Oncol.
11:736104.
doi: 10.
3389/fonc.
2021.
736104

Giampieri R, Lupi A, Ziranu P, Bittoni A, Pretta A, Pecci F, Persano M, Giglio E, Copparoni C, Crocetti S, Mandolesi A, Faa G, Coni P, Scartozzi M and Berardi R (2021) Retrospective Comparative Analysis of KRAS G12C vs.
Other KRAS Mutations in mCRC Patients Treated With First-Line Chemotherapy Doublet + Bevacizumab Front Oncol 11:.
.
.
736104 doi:.
10.
3389 / fonc.
2021.
736104 in this message

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