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2015 ; 16
(12
): 1726-37
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gab.com Text
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Molecular profiling of 6,892 colorectal cancer samples suggests different
possible treatment options specific to metastatic sites
#MMPMID26553611
El-Deiry WS
; Vijayvergia N
; Xiu J
; Scicchitano A
; Lim B
; Yee NS
; Harvey HA
; Gatalica Z
; Reddy S
Cancer Biol Ther
2015[]; 16
(12
): 1726-37
PMID26553611
show ga
Metastatic colorectal cancer (mCRC) carries a poor prognosis with an overall
5-year survival of 13.1%. Therapies guided by tumor profiling have suggested
benefit in advanced cancer. We used a multiplatform molecular profiling (MP)
approach to identify key molecular changes that may provide therapeutic options
not typically considered in mCRC. We evaluated 6892 mCRC referred to Caris Life
Sciences by MP including sequencing (Sanger/NGS), immunohistochemistry (IHC) and
in-situ hybridization (ISH). mCRC metastases to liver, brain, ovary or lung (n =
1507) showed differential expression of markers including high protein expression
of TOPO1 (52%) and/or low RRM1 (57%), TS (71%) and MGMT (39%), suggesting
possible benefit from irinotecan, gemcitabine, 5FU/capecitabine and temozolomide,
respectively. Lung metastases harbored a higher Her2 protein expression than the
primary colon tumors (4% vs. 1.8%, p = 0.028). Brain and lung metastases had
higher KRAS mutations than other sites (65% vs 59% vs 47%, respectively, p =
0.07, <0.01), suggesting poor response to anti-EGFR therapies. BRAF-mutated CRC
(n = 455) showed coincident high protein expression of RRM1 (56%), TS (53%) and
low PDGFR (22%) as compared with BRAF wild-type tumors. KRAS-mutated mCRC had
higher protein expression of c-MET (47% vs. 36%) and lower MGMT (56% vs. 63%),
suggesting consideration of c-MET inhibitors and temozolomide. KRAS-mutated CRC
had high TUBB3 (42% vs. 33%) and low Her2 by IHC (0.5%) and HER2 by FISH (3%, p
<0.05). CRC primaries had a lower incidence of PIK3CA and BRAF mutations in
rectal cancer versus colon cancer (10% and 3.3%, respectively). MP of 6892 CRCs
identified significant differences between primary and metastatic sites and among
BRAF/KRAS sub-types. Our findings are hypothesis generating and need to be
examined in prospective studies. Specific therapies may be considered for
different actionable targets in mCRC as revealed by MP.