Mutational analysis and clinical correlation of metastatic colorectal cancer.

摘要: BACKGROUND Early identification of mutations may guide patients with metastatic colorectal cancer toward targeted therapies that be life prolonging. The authors assessed tumor genotype correlations clinical characteristics to determine whether mutational profiling can account for similarities, differences, and outcomes. METHODS Under Institutional Review Board approval, 222 colon adenocarcinoma (n = 158) rectal (n = 64) who underwent genotyping were reviewed. Multiplexed screened >150 across 15 commonly mutated genes. chi-square test was used assess frequency by site additional characteristics. Cox multivariate analysis the impact on overall survival. RESULTS Broad-based revealed anatomic differences could linked gene mutations. NRAS associated versus (12.5% vs 0.6%; P < .001) age ≥56 years (7% 0.9%; P = .02). Conversely, v-raf murine sarcoma viral oncogene homolog B (BRAF) (13% 3%; P = .024) older (15.8% 4.6%; P = .006). TP53 (30% 18%; P = .048), younger (14% 28.7%; P = .007), men (26.4% 14%; P = .03). Lung metastases PIK3CA (23% 8.7%; P = .004). Only in BRAF independently decreased survival (hazard ratio, 2.4; 95% confidence interval, 1.09-5.27; P = .029). CONCLUSIONS The current study suggests underlying molecular profiles differ between cancers. Further investigation is warranted identified are important determining optimal treatment course these patients. Cancer 2014;120:1482–1490. © 2014 American Society.