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Title: Impact of circulating tumor DNA mutant allele fraction on prognosis in RAS-mutant metastatic colorectal cancer
Author: Elez, Elena
Chianese, Chiara
Sanz-García, Enrique
Martinelli, Erica
Noguerido, Alba
Mancuso, Francesco Mattia
Caratu, Ginevra
Matito, Judit
Grasselli, Julieta
Cardone, Claudia
Esposito, Riziero Esposito
Martini, Giulia
Santos, Cristina
Macarulla, Teresa
Argilés, Guillem
Capdevila, Jaume
Garcia, Ariadna
Mulet Margalef, Núria
Maiello, Evaristo
Normanno, Nicola
Jones, Frederick
Tabernero Caturla, Josep
Ciardello, Fortunato
Salazar Soler, Ramón
Vivancos, Ana
Keywords: Sang
Càncer colorectal
Mutació (Biologia)
Colorectal cancer
Mutation (Biology)
Issue Date: 1-Sep-2019
Publisher: Elsevier
Abstract: Despite major advances in the treatment of metastatic colorectal cancer (mCRC), the survival rate remains very poor. This study aims at exploring the prognostic value of RAS-mutant allele fraction (MAF) in plasma in mCRC. Forty-seven plasma samples from 37 RAS-mutated patients with nonresectable metastases were tested for RAS in circulating tumor DNA using BEAMing before first- and/or second-line treatment. RAS MAF was correlated with several clinical parameters (number of metastatic sites, hepatic volume, carcinoembryonic antigen, CA19-9 levels, primary site location, and treatment line) and clinical outcome [progression-free survival (PFS) and overall survival (OS)]. An independent cohort of 32 patients from the CAPRI-GOIM trial was assessed for clinical outcome based on plasma baseline MAF. RAS MAF analysis at baseline revealed a significant correlation with longer OS [Hazard ratios (HR) = 3.514; P = 0.00066]. Patients with lower MAF also showed a tendency to longer PFS, although not statistically significant. Multivariate analysis showed RAS MAFs as an independent prognostic factor in both OS (HR = 2.73; P = 0.006) and first-line PFS (HR = 3.74; P = 0.049). Tumor response to treatment in patients with higher MAF was progression disease (P = 0.007). Patients with low MAFs at baseline in the CAPRI-GOIM group also showed better OS [HR = 3.84; 95% confidence intervals (CI) 1.5-9.6; P = 0.004] and better PFS (HR = 2.5; 95% CI: 1.07-5.62; P = 0.033). This minimally invasive test may help in adding an independent factor to better estimate outcomes before initiating treatment. Further prospective studies using MAF as a stratification factor could further validate its utility in clinical practice.
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It is part of: Molecular Oncology, 2019, vol. 13, num. 9, p. 1827-1835
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ISSN: 1574-7891
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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