Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, School of Medicine, Seoul, Korea.
Cancer Chemother Pharmacol. 2011 Aug;68(2):317-23. doi: 10.1007/s00280-010-1496-5. Epub 2010 Oct 24.
K-ras proto-oncogene is commonly mutated in colorectal cancer (CRC) and has been associated with predictive markers for anti-EGFR (epidermal growth factor receptor) therapy. However, the prognostic role of K-ras status is still unclear. The aim of this study was to evaluate the association between k-ras status and addition of oxaliplatin to fluorouracil plus leucovorin (FOLFOX) chemotherapy in CRC patients with curative surgical resection.
Sixty-six patients with stage II or III CRC were treated with FOLFOX or fluorouracil plus leucovorin (FL) followed by curative surgery between January 2004 and October 2007. K-ras status was assessed by direct sequencing.
Fifteen patients (22.7%) had K-ras mutations of codon 12 (11/15) or codon 13 (4/15). There were no significant differences in clinicopathological parameters, such as age, sex, stage, or adjuvant regimen between the wild-type K-ras and mutant K-ras. With a median follow-up of 41.6 months (range 25.1-72.3 months), median disease-free survival (DFS) and overall survival (OS) were not reached. With regard to K-ras status, DFS and OS were not statistically different (P = 0.269 and P = 0.917, respectively). Even in the group treated with FOLFOX only, neither DFS (P = 0.651) nor OS (P = 0.265) was significantly different according to K-ras status. With the exception of tumor location in DFS and OS, no differences in other variables were observed. Proximal colon cancer patients had a longer DFS than distal CRC patients (P = 0.079); this trend was maintained only in the wild-type K-ras group (P = 0.051).
These results showed that K-ras status was not associated with clinical outcome in patients treated with adjuvant FOLFOX.
K-ras 原癌基因在结直肠癌（CRC）中经常发生突变，并且与抗表皮生长因子受体（EGFR）治疗的预测标志物相关。然而，K-ras 状态的预后作用仍不清楚。本研究旨在评估 K-ras 状态与奥沙利铂联合氟尿嘧啶加亚叶酸（FOLFOX）化疗在接受根治性手术切除的 CRC 患者中的关系。
2004 年 1 月至 2007 年 10 月期间，66 例 II 期或 III 期 CRC 患者接受 FOLFOX 或氟尿嘧啶加亚叶酸（FL）治疗，然后进行根治性手术。通过直接测序评估 K-ras 状态。
15 例患者（22.7%）存在密码子 12（11/15）或密码子 13（4/15）的 K-ras 突变。野生型 K-ras 和突变型 K-ras 之间的临床病理参数（如年龄、性别、分期或辅助治疗方案）无显著差异。中位随访 41.6 个月（范围 25.1-72.3 个月），无疾病进展生存（DFS）和总生存（OS）未达到。关于 K-ras 状态，DFS 和 OS 无统计学差异（P = 0.269 和 P = 0.917）。即使在仅接受 FOLFOX 治疗的组中，根据 K-ras 状态，DFS（P = 0.651）和 OS（P = 0.265）也无显著差异。除了 DFS 和 OS 中的肿瘤位置外，其他变量没有差异。在 DFS 和 OS 中，近端结肠癌患者的生存时间长于远端 CRC 患者（P = 0.079）；这种趋势仅在野生型 K-ras 组中维持（P = 0.051）。
这些结果表明，在接受辅助 FOLFOX 治疗的患者中，K-ras 状态与临床结局无关。
