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KRAS mutation analysis: a comparison between primary tumours and matched liver metastases in 305 colorectal cancer patients
Open accessAbstract
BACKGROUND: KRAS mutation is a negative predictive factor for treatment with anti-epidermal growth factor receptor antibody in metastatic colorectal cancer (CRC). KRAS mutation analysis is usually performed on primary tumour tissue because metastatic tissue is often not available. However, controversial data are available on the concordance of test results between primary tumours and corresponding metastases. We assessed the concordance of KRAS mutation status in a study of 305 primary colorectal tumours and their corresponding liver metastases. METHODS: Patients with histologically confirmed CRC who underwent surgical resection of the primary tumour and biopsy or surgical resection of the corresponding liver metastasis were included. KRAS mutation analysis was performed for codons 12 and 13. RESULTS: KRAS mutation was detected in 108 out of 305 primary tumours (35.4%). In 11 cases (3.6%), we found a discordance between primary tumour and metastasis: 5 primary tumours had a KRAS mutation with a wild-type metastasis, 1 primary tumour was wild type with a KRAS mutation in the metastasis, and in 5 cases the primary tumour and the metastasis had a different KRAS mutation. CONCLUSION: We observed a high concordance of KRAS mutation status of 96.4% (95% CI 93.6-98.2%) between primary colorectal tumours and their corresponding liver metastases. In only six patients (2.0%; 95% CI 0.7-4.2%), the discordance was clinically relevant. In this largest and most homogenous study to date, we conclude that both primary tumours and liver metastases can be used for KRAS mutation analysis.
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“discordance in KRAS mutation status is rare in distant organ metastases (less than 10%) [52,53]”
From The Role of KRAS Mutations in Colorectal Cancer: Biological Insights, Clinical Implications, and Future Therapeutic Perspectives (2025) · cites this paper as [53]
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Metadata
- Authors
- Knijn, N., Mekenkamp, L. J. M., Klomp, M., Vink-Börger, M. E., Tol, J., Teerenstra, S., Meijer, J. W. R., Tebar, M., Riemersma, S., van Krieken, J. H. J. M., Punt, C. J. A., & Nagtegaal, I. D.
- Affiliations
- Radboud University Medical Center (NL)
- Rijnstate Hospital (NL)
- Corresponding author
- Nagtegaal, I D
- Venue
- British Journal of Cancer
- Published
- 2011-03
- Volume
- 104
- Issue
- 6
- Pages
- 1020-1026
- ISSN
- 0007-0920 (ISSN-L)
- 1532-1827
- PMC
- PMC3065268
- OpenAlex
- W2011288277
- Cited by
- 291
- References
- 34
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 11 · 2022: 8 · 2021: 15 · 2020: 21 · 2019: 20 · 2018: 20 · 2017: 30 · 2016: 31 · 2015: 24 · 2014: 33 · 2013: 21 · 2012: 34
- FWCI
- 14.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-sa
- www.springer.com/tdm (unspecified)
- Locations
- British Journal of Cancer (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- Dutch Colorectal Cancer Group
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
- Keywords
- KRAS mutation, colorectal cancer, liver metastasis, primary tumor, codon 12 and 13 mutations, anti-EGFR antibody therapy, predictive biomarkers
- MeSH terms
- Aged, Carcinoma, DNA Mutational Analysis, Female, Humans, Liver Neoplasms, Male, Middle Aged, Models, Biological, Mutation, Genes, ras, Colorectal Neoplasms, Cohort Studies, Multicenter Studies as Topic, Matched-Pair Analysis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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