Prognostic Impact of RAS and TP53 Mutation Profiles in Metastatic Colorectal Cancer

Rákkutatás · Colorectal cancer · KRAS · TP53 · BRAF

The RASm/TP53w mutation profile is associated with significantly shorter overall survival in metastatic colorectal cancer patients compared with the RASw/TP53w profile.

Background and Objectives: Our study aimed to investigate the effect of RAS and TP53 mutations, either alone or in combination, on survival in patients with metastatic colorectal carcinoma (mCRC). Materials and Methods: 155 mCRC patients treated between January 2019 and November 2023 were evaluated retrospectively. Somatic mutation analysis was performed by next‑generation sequencing (NGS). Survival was assessed using Kaplan‑Meier and Cox regression analyses. Results: RAS mutations were present in 42.5% of patients and TP53 mutations in 39.9%. Patients were classified into four groups: RASm/TP53w (35.4%), RASw/TP53w (30.9%), RASw/TP53m (20%), and RASm/TP53m (13.5%). The RASm/TP53w group had the lowest median progression‑free survival (7.3 months) and median overall survival (16.9 months). Median OS was significantly lower in the RASm/TP53w group compared to the RASw/TP53w group (16.9 months vs. 26.0 months, p = 0.003). Multivariate Cox regression identified RASm/TP53w as an independent prognostic factor for decreased OS. Conclusions: In mCRC, the RASm/TP53w mutation profile predicts poorer overall survival and may serve as a prognostic biomarker.

Identifying RAS and TP53 co‑mutation patterns can refine prognostic assessment and guide therapeutic decisions in metastatic colorectal cancer, potentially influencing the selection of anti‑EGFR or other targeted therapies.

Bizonyítékszint: Korai humán adat. Kis vagy feltáró emberi adat.

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