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Association details:
| Biomarker: | NRAS mutation |
|---|---|
| Cancer: | Colorectal Cancer |
| Drug: | Avastin (bevacizumab) (VEGF-A inhibitor) |
| Direction: | Sensitive |
Evidence:
Source:
Title:
Neoadjuvant Bevacizumab + Chemotherapy Combined With Short-course Radiotherapy
Excerpt:
...An ARMS-PCR proven KRAS, NRAS mutation, excluding BRAF mutation or microsatellite instablility-High; 3....
Trial ID:
Source:
Title:
Refractory advanced colorectal cancer in the treatment with integrated traditional Chinese and western medicine: a multi-center clinical study
Excerpt:
...RAS mutation (including KRAS, NRAS and HRAS); 5. ...
Trial ID:
Less C2 evidence
Source:
Title:
Safety and efficacy of trifluridine/tipiracil plus bevacizumab in RAS mutated patients with metastatic colorectal cancer
Published date:
05/25/2023
Excerpt:
Forty-two patients were enrolled. Median age was 67 years (range 41–79 years), 44% were male, 100% had an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0–1, 85% were KRAS and 15% NRAS mutant...DCR was 57.1% (90% CI, 44.6 %-69.3%, P = 0.0690), respectively. The median progression-free survival (PFS) was 4.6 months...FTD/TPI is an important therapeutic resource in refractory RAS mutated metastatic colorectal cancer that combines manageability and safety.
Secondary therapy:
trifluridine/tipiracil
DOI:
10.1200/JCO.2023.41.16_suppl.e15605
Source:
Title:
Dynamic changes in RAS gene status in circulating tumour DNA: a phase II trial of first-line FOLFOXIRI plus bevacizumab for RAS-mutant metastatic colorectal cancer (JACCRO CC-11)
Published date:
06/07/2022
Excerpt:
Therefore, this study aimed to carry out a biomarker analysis by liquid biopsy using updated data of the phase II trial of FOLFOXIRI plus bevacizumab as first-line chemotherapy for RAS-mutant mCRC. The levels of circulating tumour DNA (ctDNA) and specific KRAS and NRAS variants were evaluated using real-time PCR assays. ORR was 75.8% (95% confidence interval 65.1% to 86.5%). The median progression-free survival was 12.1 months, and the median overall survival (OS) was 30.2 months. Survival analysis indicated that the median OS from progression was significantly longer in patients with RAS mutation clearance than in those with RAS mutation in the ctDNA at disease progression (15.1 versus 7.3 months, hazard ratio: 0.21, P = 0.0046).
Secondary therapy:
FOLFOXIRI
DOI:
10.1016/j.esmoop.2022.100512
Source:
Title:
Metastatic colorectal cancer in both sides of Aegean Sea: practice patterns and outcome
Published date:
02/03/2022
Excerpt:
RAS and BRAF mutation rates were found to be 36% and 39%, respectively. As first-line therapy, 196 (54%) patients received bevacizumab and Anti-EGFR treatments in combination with chemotherapy….Objective response rate was 42% (n = 152) and 32% (n = 78) for 1st line and 2nd line treatments, respectively. While the median progression free survival (PFS) with the 1st line treatment was 10 months, it was 7 months with the 2nd line treatments. In the total study population median PFS and overall survival (OS) were 10 (95% CI, 8.3 - 11.6) and 35 (95% CI, 30.7 - 39.2) months, respectively.... it was found that wild RAS and BRAF mutations and second metastasectomy contributed to overall survival (p = 0.047 and p < 0.001).
Secondary therapy:
Chemotherapy
DOI:
https://doi.org/10.1080/03007995.2022.2037848
Source:
Title:
Chemotherapy (doublet or triplet) plus targeted therapy by RAS status as conversion therapy in colorectal cancer patients with initially unresectable liver-only metastases. The UNICANCER PRODIGE-14 randomised clinical trial
Published date:
01/06/2022
Excerpt:
PRODIGE 14 was an open-label, multicenter, randomised Phase 2 trial. CRC patients with initially defined unresectable liver-only metastases received either, 2-CTx (FOLFOX or FOLFIRI) or 3-CTx (FOLFIRINOX), plus bevacizumab/cetuximab by RAS status. We failed to increase from 50 to 70% the R0/R1 liver-resection rate with the use of 3-CTx combined with bevacizumab or cetuximab by RAS status in CRC patients with initially unresectable liver metastases.
Secondary therapy:
FOLFIRINOX
DOI:
10.1038/s41416-021-01644-y
Source:
Title:
Bevacizumab Plus mFOLFOX6 Versus mFOLFOX6 Alone as First-Line Treatment for RAS Mutant Unresectable Colorectal Liver-Limited Metastases: The BECOME Randomized Controlled Trial
Published date:
08/05/2020
Excerpt:
For patients with initially unresectable RAS mutant colorectal liver metastases, bevacizumab combined with mFOLFOX6 increased the resectability of liver metastases and improved response rates and survival compared with mFOLFOX6 alone.
Secondary therapy:
mFOLFOX6
DOI:
10.1200/JCO.20.00174
Source:
Title:
Phase II randomised study of maintenance treatment with bevacizumab or bevacizumab plus metronomic chemotherapy after first-line induction with FOLFOXIRI plus Bevacizumab for metastatic colorectal cancer patients: the MOMA trial
Excerpt:
Between May 2012 and March 2015, 232 patients, mostly with RAS (65%) or BRAF (9%) mutant tumours, were randomised in 16 Italian centres....The activity of FOLFOXIRI plus bevacizumab is confirmed in a population with high prevalence of RAS/BRAF mutations treated with a 4-months induction.
Secondary therapy:
FOLFOXIRI
DOI:
10.1016/j.ejca.2018.12.028
Trial ID:
