Cancer Res Treat.  2014 Jan;46(1):48-54.

Dose KRAS Mutation Status Affect on the Effect of VEGF Therapy in Metastatic Colon Cancer Patients?

• Kim ST
• Park KH
• Shin SW
• Kim YH

Abstract

PURPOSE
Mutations affecting the KRAS gene are an established negative predictor for anti-epidermal growth factor receptor (anti-EGFR) therapies in metastatic colorectal cancer (CRC). However, the role of KRAS mutation as a biomarker for anti-vascular endothelial growth factor (VEGF) remains controversial.
MATERIALS AND METHODS
We analyzed retrospective data from 32 CRC patients who were available for KRAS mutation status and received cytotoxic chemotherapy plus bevacizumab as a first-line therapy. Six of 32 patients received anti-EGFR therapies. We used KRAS mutation status as a predictive or prognostic factor in CRC patients receiving bevacizumab.
RESULTS
We observed mutations in KRAS in 59.4% of patients. Bevacizumab was used in combination with oxaliplatin based regimens. There was no significant difference for progression free survival (PFS) and overall survival (OS) in patients with oxaliplatin based cytotoxic chemotherapy plus bevacizumab according to the status of KRAS mutation. After first-line therapy, 28 patients (87.5%) received second-line therapy. In univariate analysis, KRAS mutations did not have a major prognostic value for PFS (hazard ratio, 1.007; 95% confidence interval [CI], 0.469 to 2.162; p>0.05) or OS (hazard ratio, 0.548; 95% CI, 0.226 to 1.328; p>0.05). In addition, anti-EGFR therapies did not affect the impact on OS.
CONCLUSION
KRAS mutation is neither a predictive for bevacizumab nor a prognostic for OS in CRC patients receiving anti-VEGF therapy.

Keyword

KRAS; Vascular endothelial growth factor; Colonic neoplasms

MeSH Terms

Colon*
Colonic Neoplasms*
Colorectal Neoplasms
Disease-Free Survival
Drug Therapy
Endothelial Growth Factors
Humans
Retrospective Studies
Vascular Endothelial Growth Factor A*
Bevacizumab
Endothelial Growth Factors
Vascular Endothelial Growth Factor A

Figure

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  Fig. 1 Progression free survival (PFS) to oxaliplatin chemotherapy plus anti-VEGF agents according to KRAS mutation status.

• 

  Fig. 2 Overall survival (OS) according to KRAS mutation status.

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