High concordance of KRAS status between primary colorectal tumors and related metastatic sites: Implications for clinical practice

Daniele Santini, Fotios Loupakis, Bruno Vincenzi, Irene Floriani, Irene Stasi, Emanuele Canestrari, Eliana Rulli, Paolo Enrico Maltese, Francesca Andreoni, Gianluca Masi, Francesco Graziano, Giacomo Giulio Baldi, Lisa Salvatore, Antonio Russo, Giuseppe Perrone, Maria Rosa Tommasino, Mauro Magnani, Alfredo Falcone, Giuseppe Tonini, Annamaria Ruzzo

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. Several studies have suggested that KRAS somatic mutations may predict resistance to cetuximab-and panitumumab-based treatments in metastatic colorectal cancer (CRC) patients. Nevertheless, most experiences were conducted on samples from primaries. The aim of this study was to evaluate the grade of concordance in terms of KRAS status between primaries and related metastases. Patients and Methods. We analyzed KRAS codon 12 and 13 mutations from formalin-fixed sections of 107 CRC primaries and related metastases. Eight pairs were excluded from the analysis because of the low amount of tumor tissue in the available samples. The main characteristics were: 50 men, 49 women; median age at diagnosis, 71 years (range, 41-84). The metastatic sites analyzed were the liver in 80 patients (80.8%), lung in seven patients (7.1%), and other sites in 12 patients (12.1%). Results. A KRAS mutation was found in 38 (38.4%) primary tumors and in 36 (36.4%) related metastases. The rate of concordance was 96.0% (95% confidence interval, 90.0%-98.9%). Discordance was observed in only four (4%) patients. Conclusions. Our results indicate that the detection of KRAS mutations in either primary or metastatic tumors from patients with CRC is concordant and this assessment could be used to predict response to targeted therapies such as cetuximab and panitumumab.

Original languageEnglish
Pages (from-to)1270-1275
Number of pages6
JournalThe oncologist
Volume13
Issue number12
DOIs
Publication statusPublished - Dec 2008

Keywords

  • Colorectal cancer
  • Concordance
  • Kras mutations
  • Metastatic sites
  • Primary tumors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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