Oxaliplatin-based Chemotherapy Might Provide Longer Progression-Free Survival in KRAS Mutant Metastatic Colorectal Cancer |
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Authors: | Yu-Lin Lin Jau-Yu Liau Shan-Chi Yu Li-Hui Tseng Liang-In Lin Jin-Tung Liang Ben-Ren Lin Ji-Shiang Hung Yih-Leong Chang Kun-Huei Yeh Ann-Lii Cheng |
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Institution: | 2. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan;3. Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan;4. Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan;5. Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan;11. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan;12. Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan;8. Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan;9. Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan |
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Abstract: | The identification of better regimens in currently available chemotherapeutic agents is crucial for treating patients with KRAS mutant metastatic colorectal cancer (mCRC). Records of mCRC patients who received first-line oxaliplatin- based or irinotecan-based regimens were reviewed retrospectively. Clinicopathologic features and treatment outcome of patients with first-line progression-free survival (PFS) and overall survival (OS) in association with KRAS mutation status were analyzed using the Cox proportional hazard model. Between 2007 and 2010, a total of 118 mCRC patients were enrolled. Among them, 67 were males and 51 were females. In patients who received first-line oxaliplatin-based regimens, the PFS was significantly longer in KRAS mutant patients (N = 32) than that in KRAS wild-type patients (N = 51). The median PFS was 8.5 months in KRAS mutant versus 5.8 months in KRAS wild-type patients (P = .008). In contrast, in patients who received first-line irinotecan-based regimens, the PFS was shorter in KRAS mutant patients (N = 15) than that in KRAS wild-type patients (N = 20). Median PFS was 3.9 months in KRAS mutant versus 6.0 months in KRAS wild-type patients (P = .23). Median OS between KRAS mutant and wild-type patients was not significantly different in both oxaliplatin-based and irinotecan-based regimens. In multivariate analyses, KRAS mutation remains an independent predictive factor for longer PFS in first-line oxaliplatin-based regimens. In conclusion, oxaliplatin-based chemotherapy in KRAS mutant mCRC might result in longer PFS than in KRAS wild-type mCRC. |
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