1. Loss of RAS Mutations in Liquid Biopsies of Patients With Multi-Treated Metastatic Colorectal Cancer.
- Author
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Albuquerque J, Neto da Silva D, Padrão T, Leal-Costa L, Bizarro R, Correia J, Baptista C, Machete M, Prazeres G, Margarido I, Fernandes G, Simões P, Timóteo T, Lopes F, Godinho J, Moreira-Pinto J, Rodrigues T, Faria A, Pulido C, Cirnes L, Teixeira JA, and Passos Coelho JL
- Subjects
- Humans, Retrospective Studies, Antibodies, Monoclonal therapeutic use, Liquid Biopsy, Mutation, Colorectal Neoplasms drug therapy, Colorectal Neoplasms genetics, Colorectal Neoplasms pathology, Antineoplastic Agents therapeutic use, Colonic Neoplasms, Rectal Neoplasms
- Abstract
Background: Liquid biopsy (LB) is a non-invasive tool to evaluate the heterogeneity of tumors. Since RAS mutations (RAS-mut) play a major role in resistance to antiepidermal growth factor receptor inhibitors (EGFR) monoclonal antibodies (Mabs), serial monitoring of RAS-mut with LB may be useful to guide treatment. The main aim of this study was to evaluate the prognostic value of the loss of RAS-mut (NeoRAS-wt) in LB, during the treatment of metastatic colorectal cancer (mCRC)., Methods: A retrospective study was conducted on patients with mCRC between January 2018 and December 2021. RAS-mut were examined in tissue biopsy, at mCRC diagnosis, and with LB, during treatment., Results: Thirty-nine patients with RAS-mut mCRC were studied. LB was performed after a median of 3 lines (0-7) of systemic treatment including anti-vascular endothelial growth factor (anti-VEGF) Mabs. NeoRAS-wt was detected in 13 patients (33.3%); 9 (69.2%) of them received further treatment with anti-EGFR Mabs with a disease control rate of 44.4%. Median overall survival (OS), from the date of LB testing, was 20 months in the NeoRAS-wt group and 9 months in the persistent RAS-mut group (log-rank 2.985; P = .08), with a 12-month OS of 84.6% and 57.7%, respectively. NeoRAS-wt was identified as a predictor of survival (HR = 0.29; P = .007), with an 11-month improvement in median OS and a 71% decrease in risk of death, in heavily pretreated patients., Conclusions: In conclusion, monitoring clonal evolution in mCRC by LB may provide an additional treatment line for patients with NeoRAS-wt in advanced disease., (© The Author(s) 2023. Published by Oxford University Press.)
- Published
- 2024
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