Association of prognostic value of primary tumor location in stage III colon cancer with RAS and BRAF mutational status

Autor: Julien Taieb, Jean-François Emile, Thomas Aparicio, Claire Mulot, Pierre Laurent-Puig, Josep Tabernero, Hampig Raphael Kourie, John Bridgewater, Jean-Luc Van Laethem, Ralyath Balogoun, Ramon Salazar, Enrico Mini, Pierre Michel, Côme Lepage, Karine Le Malicot, Gunnar Folprecht, Josef Thaler, Géraldine Perkins, Eric Van Cutsem, Olivier Bouché
Přispěvatelé: Service de gastroenterologie [CHU Georges Pompidou], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Service de pathologie [CHU Ambroise Paré], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Ambroise Paré, Fédération Francophone de la Cancérologie Digestive, FFCD, Université Sorbonne Paris Cité ( USPC ), Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique ( MEPPOT - U1147 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Vall d'Hebron University Hospital [Barcelona], Carl Gustav Carus University Hospital, Hôpital Erasme (Bruxelles), Service d'hépato-gastro-entérologie et cancérologie digestive [CHU de Reims], Centre Hospitalier Universitaire de Reims ( CHU de Reims ), Service d'hépato-gastro-entérologie [Hôpital Saint-Louis], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Klinikum Wels Grieskirchen, UCL Cancer Institute [University College London], University College of London [London] ( UCL ), University Hospitals Leuven [Leuven], Service d'Hépato-Gastro-Entérologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Institut d'Investigació Biomèdica de Bellvitge [Barcelone] ( IDIBELL ), Université Paris Descartes - Paris 5 ( UPD5 ), Service de gastroenterologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Université Sorbonne Paris Cité (USPC), Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique (MEPPOT - U1147), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), University College of London [London] (UCL), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Université Paris Descartes - Paris 5 (UPD5), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement
Rok vydání: 2017
Předmět:
0301 basic medicine
Oncology
Cancer Research
Colorectal cancer
medicine.medical_treatment
[ SDV.CAN ] Life Sciences [q-bio]/Cancer
0302 clinical medicine
FOLFOX
Gastrointestinal Cancer
Medicine
OXALIPLATIN
Stage (cooking)
education.field_of_study
Cetuximab
Brief Report
Gastroenterology
Prognosis
Primary tumor
3. Good health
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Life Sciences & Biomedicine
Adjuvant
medicine.drug
medicine.medical_specialty
Pronòstic mèdic
Population
[SDV.CAN]Life Sciences [q-bio]/Cancer
LEUCOVORIN
PANITUMUMAB
Stage III colon
RAS
BRAF

Folinic acid
03 medical and health sciences
Càncer colorectal
Internal medicine
Gastrointestinal cancer
education
neoplasms
Pathological
Colorectal Cancer
Splenic flexure
Science & Technology
Genetics and Genomics Oncology
business.industry
Proportional hazards model
Cancer
medicine.disease
FLUOROURACIL
digestive system diseases
METASTATIC COLORECTAL-CANCER
030104 developmental biology
business
Zdroj: JAMA oncology
JAMA oncology, American Medical Association, 2017, 〈https://jamanetwork.com/journals/jamaoncology/article-abstract/2663951?redirect=true〉. 〈10.1001/jamaoncol.2017.3695〉
Dipòsit Digital de la UB
Universidad de Barcelona
JAMA oncology, American Medical Association, 2018, 4 (7), pp.e173695. ⟨10.1001/jamaoncol.2017.3695⟩
ISSN: 1527-7755
0732-183X
2374-2437
DOI: 10.1200/jco.2017.35.15_suppl.3515
Popis: IMPORTANCE: We know of no data on the prognostic value of primary tumor location (PTL) according to BRAF, RAS, and microsatellite instability (MSI) status in patients who have undergone resection for colon cancer (CC) and have been treated with current standard adjuvant chemotherapy. OBJECTIVE: To determine the prognostic and predictive value of PTL according to BRAF, RAS, and MSI status in patients with stage III CC receiving adjuvant treatment with FOLFOX (folinic acid [leucovorin calcium], fluorouracil, and oxaliplatin) with or without cetuximab. DESIGN, SETTING, AND PARTICIPANTS: This post hoc analysis included patients with available tumor blocks of resected stage III colon adenocarcinoma who participated in the Pan-European Trials in Alimentary Tract Cancer (PETACC)-8 phase 3 randomized trial. Among the 2559 patients who underwent randomization, 1900 were screened by next-generation sequencing, which showed that 1869 had full information concerning PTL. We categorized primary tumor site as located proximal (right) or distal (left) to the splenic flexure. MAIN OUTCOMES AND MEASURES: The associations between PTL (right- vs left-sided) and disease-free survival (DFS), survival after relapse (SAR), and overall survival (OS) were assessed by Cox models and adjusted for clinical and pathological features, treatment, and MSI, BRAF, and RAS status. RESULTS: Among the 1869 patients (1056 [57%] male; mean [SD] age, 59.4 [9.5] years) with full molecular data analyzed, 755 (40%) had a right-sided tumor, 164 (10%) had MSI, 942 (50%) had RAS mutations, and 212 (11%) had BRAF mutations. Right-sided tumor location was not prognostic for DFS in the whole population but was associated with a shorter SAR (hazard ratio [HR], 1.54; 95% CI, 1.23-1.93; P = .001) and OS (HR, 1.25; 95% CI, 1.02-1.54; P = .03). When looking at DFS in the different molecular subgroups, we found similar results for microsatellite-stable tumors and tumors with MSI; a better DFS in right-sided vs left-sided tumors in patients with RAS mutations (HR, 0.80; 95% CI, 0.64-1.00; P = .046); and a worse DFS in right-sided vs left-sided tumors in patients with RAS and BRAF double wild type (HR, 1.39; 95% CI, 1.01-1.92; P = .04). These results were found independently of the treatment received, and no beneficial effect of cetuximab on DFS or OS was observed in left-sided tumors. CONCLUSIONS AND RELEVANCE: Although right-sided tumor location is associated with poor survival in patients with metastatic CC as previously reported, the association with disease recurrence appears to vary for patients with stage III CC and RAS or BRAF mutations vs those with double wild type. ispartof: JAMA ONCOLOGY vol:4 issue:7 ispartof: location:United States status: published
Databáze: OpenAIRE