The temporal evaluation of RAS and BRAF mutation by liquid biopsy at progression after bevacizumab combinations in patients with metastatic colorectal cancer (mCRC).

Authors

null

Irem Bilgetekin

Department of Medical Oncology, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey

Irem Bilgetekin , Mehmet Dogan , Cengiz Karacin , Fatma Bugdayci Basal , Ece Esin , Gokhan Ucar , Ozlem Aydin Isak , Goksen Inanc Imamoglu , Gul Sema Yildiran Keskin , Ismail Erturk , Burak Yasin Aktas , Naziyet Kose Baytemur , Kubra Aydin , Selcuk Cemil Ozturk , Bulent Aksel , Nuri Karadurmus , Olcay Kandemir , Berna Oksuzoglu , Umut Demirci

Organizations

Department of Medical Oncology, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey, Department of Pathology, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey, Department of Medical Oncology, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, TN, Turkey, Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey, Department of Medical Oncology, University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, Department of Medical Oncology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey, Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06100, Turkey, Ankara, Turkey, Department of Medical Oncology, Memorial Ankara Hospital, Uskudar University, Ankara ,Turkey, Ankara, Turkey, Department of General Surgery, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey, Department of Pathology, University of Health Sciences, Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey, Ankara, Turkey

Research Funding

No funding received
None

Background: Expanded RAS analysis is essential for the selection of biologic agents in mCRC. RAS mutations indicates anti-EGFR unresponsiveness. In this study, we aimed to investigate RAS and BRAF mutations by liquid biopsy at progression in patients with RAS mutant mCRC. Methods: Sixty patients with mCRC who harbored tissue RAS mutations were prospectively analyzed between July 2019 and April 2020. All the patients treated with chemotherapy plus bevacizumab combinations . The plasma samples of the patients were analyzed after progression of bevacizumab combinations. RAS mutation profile was evaluated in plasma using Idylla PCR-based molecular diagnostics method, which enables rapid detection of common mutations in RAS and BRAF genes in circulating tumor DNA (ctDNA). Kaplan-Meier method was used for survival analysis and log-rank test was performed for comparison of groups. Results: The median age of the patients was 60 years (IQR:35-83 years) and female was (n=23, 38.3%). Primary tumor was located in the left colon in 81.7% of all patients. There were 95.0% KRAS and 5% NRAS mutations in baseline tissue biopsy. As a result of liquid biopsy after progression, 55.0% of the patients had KRAS, 3.3% NRAS and 3.3% had BRAF mutations. The RAS mutation detected in 58.3% of the patients. While there was no significant difference in terms of clinicopathological features between wild type (RAS/BRAF) and mutant type (RAS/BRAF) determined by liquid biopsy, the overall survival (OS) of the wild type group was significantly longer than mutant group (43.8 vs. 20.4 months, p= 0.002). Conclusions: This study demonstrated that there may be changes in RAS/BRAF mutation from plasma analysis after progression in patients with mCRC. Since better survival in the patient group with wild type was detected compared to the RAS concordance group, the evaluation of RAS mutation status at the time of progression may be important in terms of disease prognosis and treatment options.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr e15587)

DOI

10.1200/JCO.2021.39.15_suppl.e15587

Abstract #

e15587

Abstract Disclosures