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Albuquerque J, Neto da Silva D, Padrão T, Leal-Costa L, Bizarro R, Correia J, Baptista C, Machete M, Prazeres G, Margarido I, Fernandes G, Simões P, Timóteo T, Lopes F, Godinho J, Moreira-Pinto J, Rodrigues T, Faria A, Pulido C, Cirnes L, Teixeira JA, Passos Coelho JL. Loss of RAS Mutations in Liquid Biopsies of Patients With Multi-Treated Metastatic Colorectal Cancer. Oncologist 2024; 29:e337-e344. [PMID: 38071748 PMCID: PMC10911918 DOI: 10.1093/oncolo/oyad299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/17/2023] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Liquid biopsy (LB) is a non-invasive tool to evaluate the heterogeneity of tumors. Since RAS mutations (RAS-mut) play a major role in resistance to antiepidermal growth factor receptor inhibitors (EGFR) monoclonal antibodies (Mabs), serial monitoring of RAS-mut with LB may be useful to guide treatment. The main aim of this study was to evaluate the prognostic value of the loss of RAS-mut (NeoRAS-wt) in LB, during the treatment of metastatic colorectal cancer (mCRC). METHODS A retrospective study was conducted on patients with mCRC between January 2018 and December 2021. RAS-mut were examined in tissue biopsy, at mCRC diagnosis, and with LB, during treatment. RESULTS Thirty-nine patients with RAS-mut mCRC were studied. LB was performed after a median of 3 lines (0-7) of systemic treatment including anti-vascular endothelial growth factor (anti-VEGF) Mabs. NeoRAS-wt was detected in 13 patients (33.3%); 9 (69.2%) of them received further treatment with anti-EGFR Mabs with a disease control rate of 44.4%. Median overall survival (OS), from the date of LB testing, was 20 months in the NeoRAS-wt group and 9 months in the persistent RAS-mut group (log-rank 2.985; P = .08), with a 12-month OS of 84.6% and 57.7%, respectively. NeoRAS-wt was identified as a predictor of survival (HR = 0.29; P = .007), with an 11-month improvement in median OS and a 71% decrease in risk of death, in heavily pretreated patients. CONCLUSIONS In conclusion, monitoring clonal evolution in mCRC by LB may provide an additional treatment line for patients with NeoRAS-wt in advanced disease.
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Affiliation(s)
| | | | - Teresa Padrão
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
| | - Luísa Leal-Costa
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Rita Bizarro
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Jorge Correia
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
| | - Carlota Baptista
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Madalena Machete
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Gil Prazeres
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
| | - Inês Margarido
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
| | | | - Pedro Simões
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Teresa Timóteo
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
| | - Fábio Lopes
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - João Godinho
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - João Moreira-Pinto
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Tânia Rodrigues
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
| | - Ana Faria
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
| | - Catarina Pulido
- Department of Medical Oncology, Hospital da Luz, Lisboa, Portugal
| | - Luís Cirnes
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
| | - José A Teixeira
- Department of Medical Oncology, Hospital Beatriz Ângelo, Loures, Portugal
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