title: Prognostic role of KRAS, NRAS, BRAF and PIK3CA mutations in advanced colorectal cancer.
abstract: OBJECTIVE
  To explore the prognostic value of extended mutational profiling for metastatic colorectal cancer (mCRC).
  
  
  METHODS
  We retrospectively reviewed survival results of 194 mCRC patients that were assigned to four molecular subgroups: BRAF mutated; KRAS mutated codons 12-13 only; any of KRAS codons 61-146, PIK3CA or NRAS mutations and all wild-type. Point mutations were investigated by pyrosequencing.
  
  
  RESULTS
  BRAF (5.2%) and KRAS 12-13 (31.9%) mutations were associated with poorer survival (HR 2.8 and 1.76, respectively). Presenting with right-sided colon cancer, not resected primary tumor, WBC >10 × 10(9)/l, receiving less chemotherapy or no bevacizumab were all associated with inferior outcome. The all-wild-type subgroup (39.2%) reported the longest survival.
  
  
  CONCLUSIONS
  Extended mutational profile combined with clinical factors may impact on survival in mCRC.
authors: Department of Oncology, University Hospital 'S Maria della Misericordia', Piazzale S Maria della Misericordia 15, Udine, Italy.
authors: Luisa
authors: L
authors: Foltran
authors: Giovanna
authors: G
authors: De Maglio
authors: Nicoletta
authors: N
authors: Pella
authors: Paola
authors: P
authors: Ermacora
authors: Giuseppe
authors: G
authors: Aprile
authors: Elena
authors: E
authors: Masiero
authors: Mariella
authors: M
authors: Giovannoni
authors: Emiliana
authors: E
authors: Iaiza
authors: Giovanni Gerardo
authors: GG
authors: Cardellino
authors: Stefania Eufemia
authors: SE
authors: Lutrino
authors: Micol
authors: M
authors: Mazzer
authors: Manuela
authors: M
authors: Giangreco
authors: Federica Edith
authors: FE
authors: Pisa
authors: Stefano
authors: S
authors: Pizzolitto
authors: Gianpiero
authors: G
authors: Fasola
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D058534:Class I Phosphatidylinositol 3-Kinases; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality* / Q000473:pathology; D003131:Combined Modality Therapy; D004252:DNA Mutational Analysis; D005260:Female; D020558:GTP Phosphohydrolases / Q000235:genetics*; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D009154:Mutation; D059645:Mutation Rate; D009367:Neoplasm Staging; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics*; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D012189:Retrospective Studies; D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics*
chemical_list: C117307:KRAS protein, human; D008565:Membrane Proteins; D011518:Proto-Oncogene Proteins; D019869:Phosphatidylinositol 3-Kinases; D058534:Class I Phosphatidylinositol 3-Kinases; C484760:PIK3CA protein, human; D048493:Proto-Oncogene Proteins B-raf; D020558:GTP Phosphohydrolases; C579846:NRAS protein, human; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins
keywords: EGFR pathway; colorectal cancer; mutational profiling; prognostic factors