RRML - Mutations in the KRAS gene as a predictive biomarker of therapeutic response in patients with colorectal cancer
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Nr. 29(4)/2021 DOI:10.2478/rrlm-2021-0035
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Research article

Mutations in the KRAS gene as a predictive biomarker of therapeutic response in patients with colorectal cancer

Dragana Jugović, Marija Vukelić Nikolić, Višnja Madić, Ljiljana Branković, Radovan Milićević, Goran Stanojević, Perica Vasiljević

Correspondence should be addressed to: Dragana Jugović

Abstract:

Introduction: Despite the important role of general KRAS mutational status in the selection of an adequate therapeutic protocol in patients with colorectal cancer (CRC), studies that focus on its specific mutations and their significance on progression of disease are scarce. This study aimed to determine the significance of specific KRAS mutations in response to standard chemotherapy protocols with oxaliplatin-based (FOLFOX 4, OXFL) in the first-line and irinotecan-based chemotherapy (FOLFIRI, IFL) in the second-line therapy, and to evaluate the correlation between these mutations and clinicopathological characteristics of CRC patients. Methods: Genomic DNA was extracted from the FFPE tumour tissue sections while the KRAS mutation test was performed by using PCR methods. Results: Prevalence of KRAS gene mutations in CRC patients was 45%. Mutated KRAS was more frequent in later stages of tumor infiltrations (P =0.0017), on the right side of the colon (P= 0.0044), and in patients who developed metastases in the first 6 months after CRC diagnosis than in patients who developed metastases after 24 months (P=0.0083). In a group of patients with a poor therapeutic response to standard chemotherapy the most frequent mutations in KRAS gene were G12D and G12V (63.88%), while in a group of patients with a good response to therapeutic protocols the most prevalent mutation was G12A (66.66%). Conclusion: Our results indicate that there was a significant difference in biological behaviour between tumours harboring different mutations in KRAS gene. Overall, mutation G12A could be a novel prognostic biomarker for CRC patients treated with standard chemotherapy.

Keywords: colorectal cancer, biomarker, real-time PCR, KRAS gene

Received: 6.10.2021
Accepted: 11.10.2021
Published: 15.10.2021

 
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How to cite
Jugović D, Vukelić Nikolić M, Madić V, Branković L, Milićević R, Stanojević G, et al. Mutations in the KRAS gene as a predictive biomarker of therapeutic response in patients with colorectal cancer. Rev Romana Med Lab. 2021;29(4):365-75. DOI:10.2478/rrlm-2021-0035