KRAS Mutation as Predictor Factor in Locally Advanced Rectal Cancer

Flamarique Sonia,Campo M,Rodriguez M,Fernando Arias,Asin Gemma,Guerrero David

doi:10.31487/j.aco.2019.03.03

Abstract

Introduction: Standard treatment of locally advanced rectal cancer (LARC) includes neoadjuvant chemo-radiotherapy followed by total mesorectal excision (TME). The role of KRAS as a biomarker in rectal cancer remains equivocal. We evaluate the Tumor Regression Grade (TRG), Relapse-Free Survival (RFS) and Overall Survival (OS) according to the KRAS oncogene status in LARC. Material and Method: We evaluated the KRAS status in 23 patients with LARC. Tumor DNA was obtained from pretreatment biopsy tissues. Results: KRAS mutation was found in 30,4% of the patients. TRG (1-2) after CRT were 56,2% and 42,8%, for wild-type and mutant KRAS groups (p= NS). After a median follow-up of 31 months, there was no difference in RFS (47,7 vs 23,3 months) or OS (51,5 vs 30 months) between wild-type and mutant-type KRAS groups, respectively. Conclusions: Although KRAS status seems to have slightly better prognosis in LARC, it does not reach significant results (probably due to insufficient sample) in TRG, RFS or OS.

Highlights

Standard treatment of locally advanced rectal cancer (LARC) includes neoadjuvant chemoradiotherapy followed by total mesorectal excision (TME)
We evaluate the Tumor Regression Grade (TRG), Relapse-Free Survival (RFS) and Overall Survival (OS) according to the Kirsten RAS (KRAS) oncogene status in LARC Material and Method: We evaluated the KRAS status in 23 patients with LARC
Twenty-third LARC patients treated at our Hospital between January 2013 and August 2018 who received preoperative chemotherapy and radiation therapy (CRT) followed by TME, were retrospectively analyzed

Summary

Introduction

Standard treatment of locally advanced rectal cancer (LARC) includes neoadjuvant chemoradiotherapy followed by total mesorectal excision (TME). Conclusions: KRAS status seems to have slightly better prognosis in LARC, it does not reach significant results (probably due to insufficient sample) in TRG, RFS or OS. Combined chemotherapy and radiation therapy (CRT) before total mesorectal excision (TME) has become the standard treatment for patients with locally advanced rectal cancer (LARC) [1, 2]. This has shown to obtain an excellent tumor response and long- term survival [3]. A certain proportion of patients tend to experience toxicity and treatment- related complications, including leucopenia, thrombocytopenia, radiation proctitis and poor wound healing [7]

Methods

Results

Conclusion