KRAS Status as an Independent Prognostic Factor for Survival after Yttrium-90 Radioembolization Therapy for Unresectable Colorectal Cancer Liver Metastases
被引:42
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作者:
Lahti, Steven J.
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Univ Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
Lahti, Steven J.
[1
]
Xing, Minzhi
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Univ Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
Xing, Minzhi
[1
]
Zhang, Di
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机构:
Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
Zhang, Di
[3
]
Lee, James J.
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h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Med, Div Hematol Oncol, Pittsburgh, PA 15213 USA
Univ Pittsburgh, Inst Canc, Canc Therapeut Program, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
Lee, James J.
[2
,4
]
Magnetta, Michael J.
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Univ Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
Magnetta, Michael J.
[1
]
Kim, Hyun S.
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机构:
Univ Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
Univ Pittsburgh, Inst Canc, Canc Therapeut Program, Pittsburgh, PA USAUniv Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
Kim, Hyun S.
[1
,4
]
机构:
[1] Univ Pittsburgh, Sch Med, Dept Radiol, Div Intervent Radiol, Pittsburgh, PA USA
[2] Univ Pittsburgh, Sch Med, Dept Med, Div Hematol Oncol, Pittsburgh, PA 15213 USA
[3] Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA
[4] Univ Pittsburgh, Inst Canc, Canc Therapeut Program, Pittsburgh, PA USA
Purpose: To evaluate Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation status as a prognostic factor for survival after yttrium-90 (Y-90) radioembolization for colorectal cancer (CRC) liver metastases. Materials and Methods: Consecutive patients with unresectable CRC liver metastases and documented KRAS mutation status who were treated with Y-90 radioembolization during the period 2007-2014 were investigated. Patient demographics, disease characteristics, therapy regimens, and overall survival (OS) from first Y-90 radioembolization were compared between patients with KRAS wild-type (wt) and mutant status. Kaplan-Meier estimation and Cox regression were used for survival analysis and to assess independent prognostic factors for OS. Results: Of 186 patients, 104 underwent KRAS mutation analysis before Y-90 radioembolization, with 45 (43.3%) identified as mutant. The wt and mutant groups were similar in demographics, liver status, overall performance status, and tumor characteristics (all P > .05). Mean time from liver metastasis to Y-90 radioembolization was greater in patients with KRAS wt status (P = .033). A greater percentage of wt patients received anti-epidermal growth factor receptor therapies before Y-90 radioembolization (66.1% vs 8.9%; P < .001). Median OS from first Y-90 radioembolization was significantly greater in KRAS wt patients (9.5 mo vs 4.8 mo; P = .041). Univariate analysis identified Child-Pugh class, carcinoembryonic antigen (CEA), chemotherapy after Y-90 radioembolization, KRAS status, and treatment-induced toxicity as prognostic factors for OS. Multivariate Cox regression analysis demonstrated Child-Pugh class, CEA, and KRAS status to be independent prognostic factors for OS, even when correcting for the effect of chemotherapy after Y-90 radioembolization. Conclusions: Patients with CRC and KRAS wt may derive greater survival benefit from Y-90 radioembolization therapy than patients with KRAS mutant.
机构:
Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Mem Sloan Kettering Canc Ctr, Dept Radiol, 1275 York Ave, New York, NY 10065 USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Alexander, Erica S.
Petre, Elena N.
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Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Petre, Elena N.
Zhao, Ken
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Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Zhao, Ken
Sotirchos, Vlasios
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Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Sotirchos, Vlasios
Namakydoust, Azadeh
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h-index: 0
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Mem Sloan Kettering Canc Ctr, Dept Med, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Namakydoust, Azadeh
Moussa, Amgad
论文数: 0引用数: 0
h-index: 0
机构:
Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Moussa, Amgad
Yuan, Gavin
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Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Yuan, Gavin
Sofocleous, Constantinos T.
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Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Sofocleous, Constantinos T.
Solomon, Stephen B.
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Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
Solomon, Stephen B.
Ziv, Etay
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Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USAMem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY USA
机构:
Univ New S Wales, St George Hosp, Dept Surg, Sydney, NSW, AustraliaUniv New S Wales, St George Hosp, Dept Surg, Sydney, NSW, Australia
Saxena, Akshat
Chua, Terence C.
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Univ New S Wales, St George Hosp, Dept Surg, Sydney, NSW, AustraliaUniv New S Wales, St George Hosp, Dept Surg, Sydney, NSW, Australia
Chua, Terence C.
Bester, Lourens
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Univ New S Wales, St Vincents Hosp, Dept Intervent Radiol, Sydney, NSW, AustraliaUniv New S Wales, St George Hosp, Dept Surg, Sydney, NSW, Australia
Bester, Lourens
Kokandi, Adel
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Univ New S Wales, St George Hosp, Dept Surg, Sydney, NSW, AustraliaUniv New S Wales, St George Hosp, Dept Surg, Sydney, NSW, Australia
Kokandi, Adel
Morris, David L.
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机构:
Univ New S Wales, St George Hosp, Dept Surg, Sydney, NSW, AustraliaUniv New S Wales, St George Hosp, Dept Surg, Sydney, NSW, Australia
机构:
Northwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Mulcahy, Mary F.
Lewandowski, Robert J.
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Northwestern Univ, Dept Radiol, Sect Intervent Radiol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Lewandowski, Robert J.
Ibrahim, Saad M.
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Northwestern Univ, Dept Radiol, Sect Intervent Radiol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Ibrahim, Saad M.
Sato, Kent T.
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Northwestern Univ, Dept Radiol, Sect Intervent Radiol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Sato, Kent T.
Ryu, Robert K.
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Northwestern Univ, Dept Radiol, Sect Intervent Radiol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Ryu, Robert K.
Atassi, Bassel
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Northwestern Univ, Dept Radiol, Sect Intervent Radiol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Atassi, Bassel
Newman, Steven
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Northwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Newman, Steven
Talamonti, Mark
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Evanston Hosp Corp, Dept Surg, Chicago, IL USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Talamonti, Mark
Omary, Reed A.
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h-index: 0
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Northwestern Univ, Dept Radiol, Sect Intervent Radiol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Omary, Reed A.
Benson, Al, III
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Northwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Benson, Al, III
Salem, Riad
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h-index: 0
机构:
Northwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
Northwestern Univ, Dept Radiol, Sect Intervent Radiol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USANorthwestern Univ, Dept Med, Div Hematol & Oncol, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA