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RAS/BRAF突变对在直肠癌全新辅助疗法后病理完整反应的影响

Sara Aboelmaaty¹, Ibrahim A Gomaa¹, Annaclara Sileo¹

¹Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA.

Annals of surgical oncology

|July 17, 2025

概括

在直肠癌中RAS/BRAF突变与在全新辅助疗法 (TNT) 后较低的病理完整响应率有关. 这些突变还与较差的无病生存率相关,影响治疗结果.

科学领域:

在瘤学瘤学.
胃肠病学胃肠病学
遗传学遗传学是一个

背景情况:

基尔斯顿大鼠肉瘤病毒瘤基因 (KRAS) 突变在RAS突变和结直肠癌 (CRC) 中很普遍.
在直肠癌中,KRAS突变的预后意义和RAS/BRAF突变对在全新辅助疗法 (TNT) 后病理完整反应 (pCR) 的影响仍然不清楚.

研究的目的:

评估在全新辅助疗法 (TNT) 后患有RAS/BRAF突变的直肠癌患者的病理完整反应 (pCR) 率.

主要方法:

对接受了TNT和治疗性手术 (2018-2023) 的成人直肠癌患者的回顾性审查.
患者被分为RAS/BRAF突变 (RAS+) 和野生型 (RAS-) 组,不包括其他突变的患者.
分析的重点是基于RAS/BRAF突变状态的pCR率和无疾病生存率.

主要成果:

在146名患者中,47.3%是RAS+ (包括7.2%的BRAF突变).
RAS突变状态与较低的pCR率显著相关 (RAS+中的8.7%,RAS-中的20.8%,p=0.042).
在RAS+患者中,无病生存期显著降低 (在RAS-中为65%,而在RAS-中为80%,p=0.038).

结论:

RAS/BRAF突变与用TNT治疗的局部晚期直肠癌的pCR率降低有关.
这些突变还与较差的无病生存率相关,突出显示了它们的负面预后影响.

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