Molecular Profiling Use in Patients with Resectable versus Unresectable Metastatic Colorectal Cancer

Nkem J Nweze1*, Ashlie Nadler2, Elizabeth Handorf2, Biao Luo2 and Jeffrey M Farma2

1Department of Surgery, Einstein Healthcare Network, USA
2Department of Surgical Oncology, Fox Chase Cancer Center, USA

^*Correspondance to: Nkem J Nweze 

 PDF  Full Text DOI: 10.25107/2474-1647.2772

Abstract

Background: The effect of molecular profiling on clinical treatment practices in metastatic colorectal cancer remains to be elucidated. Materials and Methods: Retrospective cohort study using a tertiary referral cancer hospital clinical database (March 2006 to August 2016). Metastatic colorectal cancer patients who underwent molecular profiling were identified and divided into 2 groups: Primary Resectable vs. Primary Unresectable. Tumor molecular profile data, clinical treatments rendered and overall survival were analyzed and compared. Results: Median time from diagnosis of metastatic disease to molecular profiling was 7.7 months in the Primary Resectable group vs. 2 months in the Primary Unresectable group. Two or three mutations were detected in 58% of patients. KRAS was the most common actionable mutation. Among the KRAS mutated patients with known treatment, 59% received bevacizumab. KRAS wild type was present in 52% of patients, and 19% of this group received cetuximab or panitumumab. BRAF was mutated in 5% of our cohort, and a targeted therapy was used in 5% of this group. Median time from initial cancer diagnosis to molecular profiling was 12.2 months overall, 29.9 months in the Primary Resectable Group, and 2 months in the Primary Unresectable Group (p<0.001). Median survival time was 4.7 years overall, 5.7 years in the Primary Resectable Group, and 2.7 years in the Primary Unresectable group (p<0.001). Conclusion: There was use of a targeted therapy based on KRAS mutations identified by molecular profiling. Further research is necessary to correlate molecular profiling data, targeted therapy use and clinical trial accrual with survival outcomes in metastatic colorectal cancer patients.

Keywords

Molecular profiling; Colorectal cancer; Targeted therapy

Cite the article

Nweze NJ, Nadler A, Handorf E, Luo B, Farma JM. Molecular Profiling Use in Patients with Resectable versus Unresectable Metastatic Colorectal Cancer. Clin Surg. 2020; 5: 2772..