Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, España.
Cancer and Thrombosis Section, Spanish Society of Medical Oncology (SEOM), Madrid, Spain.
Clin Transl Oncol. 2020 Nov;22(11):2026-2031. doi: 10.1007/s12094-020-02339-1. Epub 2020 Apr 8.
There are conflicting data regarding the role of KRAS mutation on the risk of venous thromboembolism (VTE) in colorectal cancer (CRC) patients. Moreover, the role of other biomarkers such as NRAS or BRAF has not been studied.
To analyze the incidence of VTE in a cohort of patients with CRC based on KRAS, NRAS, and BRAF status.
We performed a retrospective review of patients with unresectable locally advanced and metastatic CRC (mCRC) and known KRAS/NRAS/BRAF status, attended in the Medical Oncology Department of the Hospital General Universitario Gregorio Marañón (Madrid, Spain). The primary outcome was VTE defined as any venous thromboembolic event that occurred either 6 months before or at any time after the diagnosis of CRC. The biomarker status (KRAS, NRAS, and BRAF) and other predictors of thrombosis were collected.
One hundred and ninety-four patients were identified and included in the analysis. Forty-one patients (21.1%) experienced VTE. The incidence was 19.1% in RAS-mutated patients, 28.6% in BRAF-mutated patients and 21% in triple wild-type patients (p = NS). In multivariate analysis, ECOG ≥ 2 was the only independent predictor of VTE (OR 8.73; CI 95% 1.32-57.82; p = 0.025).
In our study, biomarkers have not been associated with an increased risk of VTE in CRC patients. A high incidence of VTE in BRAF-mutated patients has been observed and should be explored in further studies.
关于 KRAS 突变在结直肠癌（CRC）患者发生静脉血栓栓塞症（VTE）的风险中的作用，存在相互矛盾的数据。此外，其他生物标志物（如 NRAS 或 BRAF）的作用尚未得到研究。
根据 KRAS、NRAS 和 BRAF 状态分析一组 CRC 患者的 VTE 发生率。
我们对西班牙马德里 Gregorio Marañón 综合医院医学肿瘤科就诊的不可切除的局部晚期和转移性 CRC（mCRC）且已知 KRAS/NRAS/BRAF 状态的患者进行了回顾性研究。主要结局是 VTE，定义为在 CRC 诊断前 6 个月或之后任何时间发生的任何静脉血栓栓塞事件。收集了生物标志物状态（KRAS、NRAS 和 BRAF）和其他血栓形成预测因素。
确定了 194 名患者并将其纳入分析。41 名患者（21.1%）发生了 VTE。RAS 突变患者的发生率为 19.1%，BRAF 突变患者为 28.6%，三野生型患者为 21%（p=NS）。在多变量分析中，ECOG≥2 是 VTE 的唯一独立预测因子（OR 8.73；95%CI 1.32-57.82；p=0.025）。
在我们的研究中，生物标志物与 CRC 患者 VTE 风险增加无关。观察到 BRAF 突变患者 VTE 的发生率较高，应在进一步研究中探讨。
