Prognostic value of molecular biomarkers in patients with metastatic colorectal cancer: a real-world study

Purpose Outcomes for patients with metastatic colorectal cancer (mCRC) have been improved by the identification of biomarkers predictive and prognostic of clinical outcome. The present retrospective analysis was undertaken to assess the utility of key biomarkers and clinical parameters in predicting outcomes in Spanish patients with mCRC. Methods We retrospectively analyzed tumor samples from a series of patients aged > 18 years with mCRC who were treated at the Hospital General Universitario Gregorio Maranon Spain. Real-time polymerase chain reaction was used to detectKRAS,NRAS,BRAF,andPIK3CAmutations. The key outcome of interest was overall survival (OS). Survival curves were estimated using the Kaplan-Meier method and stratified by the variables of greatest clinical interest. Differences were tested using the log-rank test. Results Median OS in the overall population was 24.4 months. Triple WT patients (WTKRAS, NRAS,andBRAF) and quadruple WT patients (WTKRAS, NRAS, BRAF, andPIK3CA) had significantly better OS than those who did not have triple or quadruple WT tumors. OS was significantly better in patients with left- vs. right-sided tumors, patients with resected primary tumors and metastases vs. those without resection, and patients with isolated hepatic and isolated pulmonary metastases. Conclusions This retrospective, observational study has confirmed the prognostic value of the location and resection status of the primary tumor and metastases in Spanish patients with mCRC. Triple WT status, in particular, was prognostic in this patient population, withPIK3CAadding to the prognostic value in the quadruple WT population.

Automated summary

The retrospective analysis in Spanish mCRC patients showed that triple and quadruple WT status were associated with significantly better overall survival. Patients with left-sided tumors, resected primary tumors, and isolated hepatic or pulmonary metastases also had improved survival outcomes.