Plasma central carbon metabolite changes associated with KRAS mutation and circulating tumor DNA (ctDNA) status in colorectal cancer (CRC).

Authors

null

Daniel Myung Kim

Cedars-Sinai Medical Center, Los Angeles, CA;

Daniel Myung Kim , Francesca Paola Aguirre , Alexandra Gangi , Rocio Alvarez , Lisa Zhou , Johanna ten Hoeve , Yi Jou Liao , Thomas Graeber , Andrew Eugene Hendifar , Arsen Osipov , Kamya Sankar , May Thet Cho , Anser Abbas , John Davelaar , Megan Philippa Hitchins , Jun Gong

Organizations

Cedars-Sinai Medical Center, Los Angeles, CA; , Cedars-Sinai Medical Center, West Hollywood, CA; , UCLA Metabolomics Center, Los Angeles, CA; , Olive View-UCLA Medical Center, Los Angeles, CA; , UC Irvine Health, Chao Family Comprehensive Cancer Center, Orange, CA;

Research Funding

Other
UCLA CTSI grant UL1TR001881

Background: KRAS mutations have been widely characterized as markers of poor prognosis in CRC. In stage IV CRC, KRAS mutations are predictive of benefit to anti-EGFR therapy. ctDNA has increasingly been recognized as a prognostic biomarker in CRC as well. We evaluated the association between plasma metabolites and KRAS mutation or ctDNA status in a longitudinal, observational cohort of patients with stage I-IV CRC. Methods: This was a retrospective analysis of prospectively collected blood samples from a single-institute cohort of patients with stage I-IV CRC. All blood samples were collected at pre-chemotherapy baseline. A modified Epi proColon 2.0 CE (Epigenomics AG) assay was used for plasma ctDNA testing on the methylated SEPTIN9 gene (mSEPT9). ctDNA positivity was defined as a mSEPT9 percentage of methylation reference (PMR) value greater than zero. Up to 150 metabolites of central carbon metabolism were analyzed by mass spectrometry and high-performance liquid chromatography. Analytes were compared by relative area under the curve (AUC) and differences evaluated by ANOVA. The mean AUC was used in patients with metabolites measured from > 1 timepoint of collection. Patients were stratified by ctDNA status (positive or negative) and KRAS mutant (MT) or wildtype (WT) status. Results: A total of 32 patients were included with median age 65 years (range 20-90). The majority were female (53%) and had stage IV disease (78%). Of 25 patients with stage IV CRC, 88% had pre-chemotherapy blood samples collected in the first-line setting. Most patients were KRAS MT (44%) compared to KRAS WT (37%) or unknown KRAS status (19%). The most common KRAS MT subtypes were G12D (29%), G12V (29%), G13D (21%), and G12C (14%). The mean overall survival in this cohort was 27.4 months while the mean mSEPT9 PMR value was 2553.6. When stratified by ctDNA status, ctDNA positivity was associated with decreased levels of essential amino acids (lysine, methionine, threonine) and the non-essential amino acid arginine (all p < 0.05). Compared to KRAS WT tumors, KRAS MT tumors were associated with increased levels of proline, phenylalanine, and intermediates of glycolysis (lactate), MTA cycle (SAM, 5-Methioadenosine), and O-GlcNAcylation (GlcNac, all p < 0.05). Conclusions: We are the first to demonstrate the feasibility of associating central carbon metabolites with ctDNA and KRAS mutation status. As ctDNA positivity and KRAS MT status have evolving prognostic potential in CRC, associated metabolic signatures may identify metabolic pathways for novel biomarker development. Our findings also show that KRAS MT CRC appears to be enriched in intermediates of glycolytic, methyl donor, and O-GlcNAcylation pathways.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Translational Research

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 181)

DOI

10.1200/JCO.2023.41.4_suppl.181

Abstract #

181

Poster Bd #

K3

Abstract Disclosures

Similar Abstracts

Abstract

2024 ASCO Gastrointestinal Cancers Symposium

Association of candidate alterations with primary resistance to KRAS G12D targeting in colorectal cancer.

First Author: Khalid Jazieh

Abstract

2023 ASCO Gastrointestinal Cancers Symposium

Circulating tumor DNA–based genomic landscape of KRAS wild-type pancreatic adenocarcinoma.

First Author: Brendon Fusco

First Author: Brian William Labadie

Abstract

2023 ASCO Annual Meeting

The clinical and genomic characteristics of KRAS G12D mutated cancers.

First Author: Guomin Lin