Clinicopathological features and prognostic roles of KRAS, BRAF, PIK3CA and NRAS mutations in advanced gastric cancer

被引:41
作者
Takahashi N. [1 ]
Yamada Y. [1 ]
Taniguchi H. [2 ]
Fukahori M. [1 ]
Sasaki Y. [1 ]
Shoji H. [1 ]
Honma Y. [1 ]
Iwasa S. [1 ]
Takashima A. [1 ]
Kato K. [1 ]
Hamaguchi T. [1 ]
Shimada Y. [1 ]
机构
[1] Gastrointestinal Oncology Division, National Cancer Center Hospital, Chuo-ku, Tokyo 104-0045
[2] Division of Pathology, National Cancer Center Hospital, Chuo-ku, Tokyo 104-0045
关键词
Overall Survival; Advanced Gastric Cancer; KRAS Mutation; PIK3CA Mutation; Molecular Target Therapy;
D O I
10.1186/1756-0500-7-271
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学科分类号
摘要
Background: RAS-RAF-MEK-ERK and PI3K-AKT pathways form a significant cascade for potential molecular target therapy in advanced cancer. The clinical significance of mutations in these genes in advanced gastric cancer (AGC) is uncertain. Methods. We collected formalin-fixed, paraffin-embedded and fresh frozen tumor samples from AGC patients and analyzed the KRAS, NRAS, BRAF and PIK3CA mutations by direct-sequencing. We retrospectively investigated the clinicopathological features of these mutations in AGC patients, and selected patients with metastatic gastric cancer. Results: Among 167 AGC patients, mutations of KRAS codons 12/13 (N = 8/164, 4.9%), PIK3CA (N = 9/163, 5.5%), and NRAS codon 12/13(N = 3/159, 1.9%) were detected. Comparison of the clinicopathological features of the mutated KRAS, PIK3CA, NRAS genes with an all-wild type of these genes showed that the frequency of the intestinal type was significantly higher in patients whose tumor tissue contained KRAS mutations (P = 0.014). Among 125 patients with metastatic gastric cancer, patients with NRAS codon 12/13 mutations in their tumors had shorter overall survival compared with NRAS wild-type patients (MST: 14.7 vs 8.8 months, P = 0.011). By multivariate analyses, NRAS codon 12/13 mutation was an indicator for poor prognosis in patients with metastatic gastric cancer (adjusted HR 5.607, 95% CI: 1.637-19.203). Conclusions: Our study indicated that mutations of KRAS, PIK3CA and NRAS were rare in AGC. NRAS mutations were likely to associate with poor prognosis in metastatic state of AGC patients, but further validation of other research is required. © 2014 Takahashi et al.; licensee BioMed Central Ltd.
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共 29 条
  • [21] Lee J.W., Soung Y.H., Kim S.Y., Lee H.W., Park W.S., Nam S.W., Kim S.H., Lee J.Y., Yoo N.J., Lee S.H., PIK3CA gene is frequently mutated in breast carcinomas and hepatocellular carcinomas, Oncogene, 24, 8, pp. 1477-1480, (2005)
  • [22] Karakas B., Bachman K.E., Park B.H., Mutation of the PIK3CA oncogene in human cancers, British Journal of Cancer, 94, 4, pp. 455-459, (2006)
  • [23] Mao C., Yang Z.Y., Hu X.F., Chen Q., Tang J.L., PIK3CA exon 20 mutations as a potential biomarker for resistance to anti-EGFR monoclonal antibodies in KRAS wild-type metastatic colorectal cancer: A systematic review and meta-analysis, Ann Oncol, 23, pp. 1518-1525, (2012)
  • [24] Catasus L., Gallardo A., Cuatrecasas M., Prat J., PIK3CA mutations in the kinase domain (exon 20) of uterine endometrial adenocarcinomas are associated with adverse prognostic parameters, Modern Pathology, 21, 2, pp. 131-139, (2008)
  • [25] Kalinsky K., Jacks L.M., Heguy A., Patil S., Prat J., PIK3CA mutation associates with improved outcome in breast cancer, Clin Cancer Res, 15, pp. 5049-5059, (2009)
  • [26] Janku F., Garrido-Laguna I., Petruzelka L.B., Stewart D.J., Kurzrock R., Novel therapeutic targets in non-small cell lung cancer, J Thorac Oncol, 6, pp. 1601-1612, (2011)
  • [27] Jakob J.A., Bassett Jr. L.R., Ng C.S., Curry J.L., Joseph R.W., Alvarado G.C., Rohlfs M.L., Richard J., Gershenwald J.E., Kim K.B., Lazar A.J., Hwu P., Davies M.A., NRAS mutation status is an independent prognostic factor in metastatic melanoma, Cancer, 118, pp. 4014-4023, (2012)
  • [28] Aly R.M., El-Sharnoby M.R., Hagag A.A., Prognostic significance of NRAS gene mutations in children with acute myelogenous leukemia, Mediterr J Hematol Infect Dis, 3, (2011)
  • [29] De Roock W., Claes B., Bernasconi D., De Schutter J., Biesmans B., Fountzilas G., Kalogeras K.T., Kotoula V., Papamichael D., Laurent-Puig P., Penault-Llorca F., Rougier P., Vincenzi B., Santini D., Tonini G., Cappuzzo F., Frattini M., Molinari F., Saletti P., De Dosso S., Martini M., Bardelli A., Siena S., Sartore-Bianchi A., Tabernero J., Macarulla T., Di Fiore F., Gangloff A.O., Ciardiello F., Pfeiffer P., Effects of KRAS, BRAF, NRAS and PIK3CA mutations on the efficacy of cetuximab plus che