High Concordance of KRAS Status Between Primary Colorectal Tumors and Related Metastatic Sites: Implications for Clinical Practice

Santini, Daniele; Loupakis, Fotios; Vincenzi, Bruno; Floriani, Irene; Stasi, Irene; Canestrari, Emanuele; Rulli, Eliana; Maltese, Paolo Enrico; Andreoni, Francesca; Masi, Gianluca; Graziano, Francesco; Baldi, Giacomo Giulio; Salvatore, Lisa; Russo, Antonio; Perrone, Giuseppe; Tommasino, Maria Rosa; Magnani, Mauro; Falcone, Alfredo; Tonini, Giuseppe; Ruzzo, Annamaria

doi:10.1634/theoncologist.2008-0181

Cited by 235Colorectal Cancer Treatments and StudiesColorectal Cancer Surgical TreatmentsGenetic factors in colorectal cancer

High Concordance of KRAS Status Between Primary Colorectal Tumors and Related Metastatic Sites: Implications for Clinical Practice

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Santini, Daniele, Loupakis, Fotios, Vincenzi, Bruno, Floriani, Irene, Stasi, Irene, Canestrari, Emanuele, Rulli, Eliana, Maltese, Paolo Enrico +12 more·2008·The Oncologist

DOI 10.1634/theoncologist.2008-0181

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Abstract

Purpose.: Several studies have suggested that KRAS somatic mutations may predict resistance to cetuximab- and panitumumab-based treatments in metastatic colorectal cancer (CRC) patients. Nevertheless, most experiences were conducted on samples from primaries. The aim of this study was to evaluate the grade of concordance in terms of KRAS status between primaries and related metastases. Patients and Methods.: We analyzed KRAS codon 12 and 13 mutations from formalin-fixed sections of 107 CRC primaries and related metastases. Eight pairs were excluded from the analysis because of the low amount of tumor tissue in the available samples. The main characteristics were: 50 men, 49 women; median age at diagnosis, 71 years (range, 41–84). The metastatic sites analyzed were the liver in 80 patients (80.8%), lung in seven patients (7.1%), and other sites in 12 patients (12.1%). Results.: A KRAS mutation was found in 38 (38.4%) primary tumors and in 36 (36.4%) related metastases. The rate of concordance was 96.0% (95% confidence interval, 90.0%–98.9%). Discordance was observed in only four (4%) patients. Conclusions.: Our results indicate that the detection of KRAS mutations in either primary or metastatic tumors from patients with CRC is concordant and this assessment could be used to predict response to targeted therapies such as cetuximab and panitumumab. Learning Objectives: After completing this course, the reader should be able to: Describe the importance of KRAS mutations in CRC patients.Explain the relevance to cancer treatment of concordance of KRAS status between primary tumors and metastases in CRC patients.Discuss the impact of KRAS mutations as a predictive/prognostic factor in CRC patients. CME This article is available for continuing medical education credit at http://CME.TheOncologist.com

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Pulmonary metastases have a markedly higher discordance rate (approximately 30%) compared to other sites.
“pulmonary metastases have shown a markedly higher discordance rate (approximately 30%) compared to other sites [54,55]”
From The Role of KRAS Mutations in Colorectal Cancer: Biological Insights, Clinical Implications, and Future Therapeutic Perspectives (2025) · cites this paper as [54]

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Authors: Santini, D., Loupakis, F., Vincenzi, B., Floriani, I., Stasi, I., Canestrari, E., Rulli, E., Maltese, P. E., Andreoni, F., Masi, G., Graziano, F., Baldi, G. G., Salvatore, L., Russo, A., Perrone, G., Tommasino, M. R., Magnani, M., Falcone, A., Tonini, G., & Ruzzo, A.
Affiliations: Università Campus Bio-Medico (IT)
University of Pisa (IT)
Mario Negri Institute for Pharmacological Research (IT)
Ospedale di Livorno (IT)
University of Urbino (IT)
San Salvatore Hospital (IT)
University of Palermo (IT)
Corresponding author: Santini, Daniele
ORCID: Santini, Daniele
Loupakis, Fotios
Vincenzi, Bruno
Canestrari, Emanuele
Rulli, Eliana
Maltese, Paolo Enrico
Andreoni, Francesca
Masi, Gianluca
Graziano, Francesco
Baldi, Giacomo Giulio
Salvatore, Lisa
Russo, Antonio
Perrone, Giuseppe
Magnani, Mauro
Falcone, Alfredo
Tonini, Giuseppe
Ruzzo, Annamaria
Venue: The Oncologist
Publisher: Oxford University Press (OUP)
Published: 2008-12-01
Volume: 13
Issue: 12
Pages: 1270-1275
ISSN: 1083-7159 (ISSN-L)
1549-490X
DOI: 10.1634/theoncologist.2008-0181
OpenAlex: W2121765653
Cited by: 234
References: 24
Citations by year: 2026: 1 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 7 · 2020: 8 · 2019: 8 · 2018: 4 · 2017: 9 · 2016: 20 · 2015: 23 · 2014: 16 · 2013: 23 · 2012: 32
FWCI: 11.64
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: other-oa
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: The Oncologist (publishedVersion)
PubMed (publishedVersion)
Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
CINECA IRIS Institutional Research information system (University of Urbino) (submittedVersion)
Topics: Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
Keywords: KRAS mutation, metastatic colorectal cancer, cetuximab resistance, predictive biomarkers, liver metastasis, lung metastasis, targeted therapy response
MeSH terms: Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Mutation, Neoplasm Metastasis, Proto-Oncogene Proteins, Genes, ras, Retrospective Studies, Colorectal Neoplasms, Proto-Oncogene Proteins p21(ras), ras Proteins, ErbB Receptors

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High Concordance of KRAS Status Between Primary Colorectal Tumors and Related Metastatic Sites: Implications for Clinical Practice

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