在患有结直肠外皮转移的患者中,特定的KRAS突变的预后值
M Tonello1, D Baratti2, P Sammartino3
1Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology IOV-IRCCS, Padua.
ESMO open
|April 13, 2024
概括
结肠直肠癌 (CRC) 中某些KRAS突变对腹转移 (PM) 的预后有不同的影响. KRASMUT1突变显示了与野生类型相似的生存率,而KRASMUT2则表明了较差的结果.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 手术瘤学手术瘤学
背景情况:
- 关于结直肠癌 (CRC) 周周转移 (PM) 的KRAS突变特征的证据有限.
- 了解这些概况对于预测治疗反应和患者的结果至关重要.
研究的目的:
- 为了确定单独的CRC PM.患者中特定KRAS突变的流行率.
- 为了评估这个患者队列中不同KRAS突变亚型的预后价值.
主要方法:
- 一项涉及意大利外科瘤学会13个意大利中心的多中心研究.
- KRAS突变亚型与临床病理特征和生存结果 (整体生存,局部无病生存,无病生存) 的相关性.
主要成果:
- 在362名分析患者中,KRAS突变在47.5%的患者中被发现.
- 确定了两个预后组:KRASMUT1 (例如,G12R,G13A) 平均寿命>120个月,以及KRASMUT2 (例如,G12A,G12C) 平均寿命31.2个月.
- 在多变量分析中,KRASMUT2突变,通常在P-循环区域,与减少GTP水解和更差的预后 (HR:OS 2.1,DFS 1.9,LDFS 2.5) 有关,与KRASMUT1不同,该突变与KRAS野生型 (KRASWT) 的生存率相似.
结论:
- 在CRC PM中存在不同的KRAS突变子组,具有不同的预后影响.
- KRASMUT1突变的预后可能与KRASWT相似,而KRASMUT2则是生存率较低的独立预测因素.
- 在更大的队列中进行进一步的研究是有必要的,以验证这些发现.
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