| Autor: |
Valladares-Ayerbes, Manuel, Safont, Maria José, González Flores, Encarnación, García-Alfonso, Pilar, Aranda, Enrique, Muñoz, Ana-Maria López, Falcó Ferrer, Esther, Cirera Nogueras, Luís, Rodríguez-Salas, Nuria, Aparicio, Jorge, Llanos Muñoz, Marta, Pimentel Cáceres, Paola Patricia, Castillo Trujillo, Oscar Alfredo, Vidal Tocino, Rosario, Salgado Fernández, Mercedes, Salud-Salvia, Antonieta, Massuti Sureda, Bartomeu, Garcia-Carbonero, Rocio, Vicente Conesa, Maria Ángeles, Lloansí Vila, Ariadna |
| Zdroj: |
Clinical & Translational Oncology; Oct2024, Vol. 26 Issue 10, p2640-2651, 12p |
| Abstrakt: |
Purpose: RAS (KRAS/NRAS) mutational status on a tumor biopsy is mandatory to guide the best treatment in metastatic colorectal cancer (mCRC). Determining the RAS mutational status by tumor-tissue biopsy is essential in guiding the optimal treatment decision for mCRC. RAS mutations are negative predictive factors for the use of EGFR monoclonal antibodies. Cell-free DNA (cfDNA) analysis enables minimally invasive monitoring of tumor evolution. Methods/patients: PERSEIDA was an observational, prospective study assessing cfDNA RAS, BRAF and EGFR mutations (using Idylla™) in first-line mCRC, RAS wild-type (baseline tumor-tissue biopsy) patients (cohort 2). Plasma samples were collected before first-line treatment, after 20 ± 2 weeks, and at disease progression. Results: 117 patients were included (103 received panitumumab + chemotherapy as first-line treatment). At baseline, 7 (6.8%) patients had RAS mutations, 4 (3.9%) BRAF mutations and no EGFR mutations were detected (cfDNA, panitumumab + chemotherapy subpopulation [panitumumab + Ch]). The baseline RAS mutational status concordance between tissue and liquid biopsies was 94.0% (93.2%, panitumumab + Ch). At 20 weeks, only one patient in the study (included in the panitumumab + Ch) had an emerging cfDNA RAS mutation. No emerging BRAF or EGFR mutations were reported. At disease progression, 6 patients had emergent mutations not present at baseline (RAS conversion rate: 13.3% [6/45]; 15.0% [6/40], panitumumab + Ch). Conclusions: The concordance rate between liquid and solid biopsies at baseline was very high, as previously reported, while our results suggest a considerable emergence of RAS mutations during disease progression. Thus, the dynamics of the genomic landscape in ctDNA may provide relevant information for the management of mCRC patients. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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