Koike Junichi, Ushigome Mitsunori, Funahashi Kimihiko, Shiokawa Hiroyuki, Kaneko Tomoaki, Arai Kenichiro, Matsuda Satoshi, Kagami Satoru, Suzuki Takayuki, Kurihara Akiharu, Shimada Hideaki, Kaneko Hironori
Hepatogastroenterology. 2014 Nov-Dec;61(136):2222-6.
BACKGROUND/AIMS: KRAS mutation is an important prognostic factor for patients with metastatic colorectal cancer receiving anti-epidermal growth factor receptor therapy. However, the influence of KRAS mutation on the response to mFOLFOX6 ± bevacizumab remains unclear.
We retrospectively analyzed 49 patients who received modified FOLFOX6 (mFOLFOX6) ± bevacizumab as first-line therapy. Genetic analysis showed that 30 patients had wild-type (WT) KRAS and 19 patients hadKRAS mutations (MT). These two groups were compared with regard to the response rate (RR), progression-free survival (PFS), and overall survival (OS).
The RR was not significantly different between the WT and MT groups, but PFS and OS were significantly better in the WT group than the MT group (PFS: 11.8 months vs. 8.7 months, p<0.01; OS: 37.8 months vs. 29.3 months, p<0.0385). A similar analysis of 27 patients who were treated with mFOLFOX6 + bevacizumab showed a better prognosis for WT patients. Multivariate analysis also revealed that KRAS mutation was an independent factor with a significant relation to PFS.
These results suggest that KRAS mutation may be a useful prognostic marker for patients with metastatic colorectal cancer receiving mFOLFOX6 ± bevacizumab therapy, especially for patients treated with mFOLFOX6 + bevacizumab.
背景/目的：KRAS突变是接受抗表皮生长因子受体治疗的转移性结直肠癌患者的重要预后因素。然而，KRAS突变对mFOLFOX6±贝伐单抗治疗反应的影响仍不清楚。
我们回顾性分析了49例接受改良FOLFOX6（mFOLFOX6）±贝伐单抗作为一线治疗的患者。基因分析显示，30例患者为野生型（WT）KRAS，19例患者为KRAS突变型（MT）。比较了这两组患者的缓解率（RR）、无进展生存期（PFS）和总生存期（OS）。
WT组和MT组的RR无显著差异，但WT组的PFS和OS显著优于MT组（PFS：11.8个月对8.7个月，p<0.01；OS：37.8个月对29.3个月，p<0.0385）。对27例接受mFOLFOX6+贝伐单抗治疗的患者进行的类似分析显示，WT患者的预后更好。多因素分析还显示，KRAS突变是与PFS显著相关的独立因素。
这些结果表明，KRAS突变可能是接受mFOLFOX6±贝伐单抗治疗的转移性结直肠癌患者，尤其是接受mFOLFOX6+贝伐单抗治疗患者的有用预后标志物。
