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Clinical impact of K-ras mutation in colorectal cancer patients treated with adjuvant FOLFOX

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Abstract

Background

K-ras proto-oncogene is commonly mutated in colorectal cancer (CRC) and has been associated with predictive markers for anti-EGFR (epidermal growth factor receptor) therapy. However, the prognostic role of K-ras status is still unclear. The aim of this study was to evaluate the association between k-ras status and addition of oxaliplatin to fluorouracil plus leucovorin (FOLFOX) chemotherapy in CRC patients with curative surgical resection.

Methods

Sixty-six patients with stage II or III CRC were treated with FOLFOX or fluorouracil plus leucovorin (FL) followed by curative surgery between January 2004 and October 2007. K-ras status was assessed by direct sequencing.

Results

Fifteen patients (22.7%) had K-ras mutations of codon 12 (11/15) or codon 13 (4/15). There were no significant differences in clinicopathological parameters, such as age, sex, stage, or adjuvant regimen between the wild-type K-ras and mutant K-ras. With a median follow-up of 41.6 months (range 25.1–72.3 months), median disease-free survival (DFS) and overall survival (OS) were not reached. With regard to K-ras status, DFS and OS were not statistically different (P = 0.269 and P = 0.917, respectively). Even in the group treated with FOLFOX only, neither DFS (P = 0.651) nor OS (P = 0.265) was significantly different according to K-ras status. With the exception of tumor location in DFS and OS, no differences in other variables were observed. Proximal colon cancer patients had a longer DFS than distal CRC patients (P = 0.079); this trend was maintained only in the wild-type K-ras group (P = 0.051).

Conclusions

These results showed that K-ras status was not associated with clinical outcome in patients treated with adjuvant FOLFOX.

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Acknowledgments

In Kyu Lee wishes to acknowledge the financial support of Sang Yoon Lee research fund, Department of Surgery, the Catholic University School of Medicine.

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Authors and Affiliations

  1. Division of Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, School of Medicine, Seoul, Korea

    Myung Hee Chang

  2. Department of Surgery, St. Mary’s Hospital, The Catholic University of Korea, School of Medicine, Seoul, Korea

    In Kyu Lee & Yoon Si

  3. Catholic Research Institutes of Medical Science, The Catholic University of Korea, Seoul, Korea

    Kyu Sang Lee

  4. Division of Oncology, Department of Internal Medicine, St. Mary’s Hospital, The Catholic University of Korea, School of Medicine, Seoul, Korea

    In-Sook Woo

  5. Division of Oncology, Department of Internal Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, School of Medicine, 665-8 Bupyeong6-dong, Bupyeong-gu, Incheon, 403-720, Korea

    Jae Ho Byun

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  1. Myung Hee Chang
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Correspondence to Jae Ho Byun.

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Myung Hee Chang and In Kyu Lee contributed equally to the work presented here.

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Chang, M.H., Lee, I.K., Si, Y. et al. Clinical impact of K-ras mutation in colorectal cancer patients treated with adjuvant FOLFOX. Cancer Chemother Pharmacol 68, 317–323 (2011). https://doi.org/10.1007/s00280-010-1496-5

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  • DOI: https://doi.org/10.1007/s00280-010-1496-5

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