Resectability, conversion, metastasectomy and outcome according to RAS and BRAF status for metastatic colorectal cancer in the prospective RAXO study
| Autor: | Aki Uutela, Emerik Osterlund, Päivi Halonen, Raija Kallio, Annika Ålgars, Tapio Salminen, Annamarja Lamminmäki, Leena-Maija Soveri, Raija Ristamäki, Kaisa Lehtomäki, Hanna Stedt, Eetu Heervä, Timo Muhonen, Juha Kononen, Arno Nordin, Ali Ovissi, Soili Kytölä, Mauri Keinänen, Jari Sundström, Lasse Nieminen, Markus J. Mäkinen, Teijo Kuopio, Ari Ristimäki, Helena Isoniemi, Pia Osterlund |
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| Přispěvatelé: | Tampere University, Department of Oncology, Clinical Medicine, Department of Clinical Chemistry, Department of Pathology, University of Helsinki, IV kirurgian klinikka, HUS Abdominal Center, Department of Surgery, HUS Comprehensive Cancer Center, Hyvinkää Hospital Area, Clinicum, South Carelia Social and Health care District Eksote, HYKS erva, HUS Medical Imaging Center, Department of Diagnostics and Therapeutics, HUSLAB, HUS Diagnostic Center, ATG - Applied Tumor Genomics |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Proto-Oncogene Proteins B-raf
Cancer Research BEVACIZUMAB 3122 Cancers colorectal cancer biomarkkerit 3121 Internal medicine leikkaushoito LIVER METASTASES etäpesäkkeet surgical oncology KRAS Humans metastasis Prospective Studies FOLFOXIRI paksusuolisyöpä Cancer och onkologi Rectal Neoplasms COLON-CANCER Metastasectomy ennusteet CHEMOTHERAPY Oncology syöpägeenit hoitotulokset Cancer and Oncology Colonic Neoplasms Mutation SURVIVAL syöpätaudit onkologia Colorectal Neoplasms prognostic markers |
| Popis: | Background Outcomes after metastasectomy for metastatic colorectal cancer (mCRC) vary with RAS and BRAF mutational status, but their effects on resectability and conversion rates have not been extensively studied. Methods This substudy of the prospective RAXO trial included 906 patients recruited between 2011 and 2018. We evaluated repeated centralised resectability assessment, conversion/resection rates and overall survival (OS), according to RAS and BRAF status. Results Patients included 289 with RAS and BRAF wild-type (RAS and BRAFwt), 529 with RAS mutated (RASmt) and 88 with BRAF mutated (BRAFmt) mCRC. Metastatic prevalence varied between the RAS and BRAFwt/RASmt/BRAFmt groups, for liver (78%/74%/61%), lung (24%/35%/28%) and peritoneal (15%/15%/32%) metastases, respectively. Upfront resectability (32%/29%/15%), conversion (16%/13%/7%) and resection/local ablative therapy (LAT) rates (45%/37%/17%) varied for RASa and BRAFwt/RASmt/BRAFmt, respectively. Median OS for patients treated with resection/LAT (n = 342) was 83/69/30 months, with 5-year OS-rates of 67%/60%/24%, while systemic therapy-only patients (n = 564) had OS of 29/21/15 months with 5-year OS-rates of 11%/6%/2% in RAS and BRAFwt/RASmt/BRAFmt, respectively. Resection/LAT was associated with improved OS in all subgroups. Conclusions There were significant differences in resectability, conversion and resection/LAT rates according to RAS and BRAF status. OS was also significantly longer for RAS and BRAFwt versus either mutant. Patients only receiving systemic therapy had poorer long-term survival, with variation according to molecular status. Clinical trial registration NCT01531621/EudraCT2011-003158-24 |
| Databáze: | OpenAIRE |
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