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Genomic mutations and histopathologic biomarkers in Y
Meaghan S Dendy1, Johannes M Ludwig1,2, Nima Kokabi1,3
1Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
Oncotarget
|September 11, 2018
Summary
Genomic mutations and tumor differentiation predict survival in patients with colorectal liver metastases receiving Y-90 radioembolization. Wild-type patients and those with well-differentiated tumors show better outcomes.
Area of Science:
- Hepatobiliary Oncology
- Interventional Radiology
- Molecular Diagnostics
Background:
- Colorectal liver metastases (CRLM) pose a significant challenge, particularly in chemorefractory cases.
- Yttrium-90 (Y-90) radioembolization is a treatment option for unresectable CRLM.
- Prognostic factors for Y-90 therapy in CRLM require further elucidation.
Purpose of the Study:
- To evaluate mutational load and histologic biomarkers as prognostic factors in patients with chemorefractory CRLM treated with Y-90 radioembolization.
- To correlate genomic status and tumor differentiation with overall survival (OS) and treatment response.
Main Methods:
- Retrospective analysis of 23 patients with CRLM undergoing Y-90 radioembolization and molecular testing.
- Analysis of common mutations (PIK3CA, KRAS, NRAS, etc.) and histopathologic grade.
- Kaplan-Meier survival estimation and Cox regression analysis were employed.
Main Results:
- Eleven patients (47.8%) had identified mutations (MUT), while 12 (52.2%) were wild type (WT).
- Median OS was significantly greater in WT patients (16.2 months) compared to MUT patients (6.5 months) (p=0.0054).
- Poorly differentiated tumors showed significantly worse survival compared to well or moderately differentiated tumors. A combined analysis revealed OS of 16.2, 8.0, and 3.8 months for WT, MUT/moderate differentiation, and MUT/poor differentiation groups, respectively (p<0.0001).
Conclusions:
- Mutational status and histopathologic grade are significant predictors of survival following Y-90 radioembolization for CRLM.
- Genomic wild-type status and better tumor differentiation correlate with improved overall survival and treatment response.
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