title: Impact of RAS and BRAF mutations on carcinoembryonic antigen production and pattern of colorectal metastases.
abstract: OBJECTIVE
  To investigate the impact of RAS and BRAF mutations on the pattern of metastatic disease and carcinoembryonic antigen (CEA) production.
  
  
  METHODS
  In this retrospective study, we investigated the impact of RAS and BRAF mutational status on pattern of metastatic disease and CEA production. Only patients presenting with a newly diagnosed metastatic colorectal cancer (CRC) were included. Patients' characteristics, primary tumor location, site of metastatic disease and CEA at presentation were compared between those with and without RAS and BRAF mutations.
  
  
  RESULTS
  Among 174 patients, mutations in KRAS, NRAS and BRAF were detected in 47%, 3% and 6% respectively. RAS mutations (KRAS and NRAS) were more likely to be found in African American patients (87% vs 13%; P value = 0.0158). RAS mutations were associated with a higher likelihood of a normal CEA (< 5 ng/mL) at presentation. BRAF mutations were more likely to occur in females. We were not able to confirm any association between mutational status and site of metastatic disease at initial diagnosis.
  
  
  CONCLUSIONS
  No association was found between RAS and BRAF mutations and sites of metastatic disease at the time of initial diagnosis in our cohort. Patients with RAS mutations were more likely to present with CEA levels < 5 ng/mL. These findings may have clinical implications on surveillance strategies for RAS mutant patients with earlier stages of CRC.
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: May
authors.initials: M
authors.lastname: Cho
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: Chie
authors.initials: C
authors.lastname: Akiba
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Lau
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: David
authors.initials: D
authors.lastname: Smith
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: Milhan
authors.initials: M
authors.lastname: Telatar
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: Michelle
authors.initials: M
authors.lastname: Afkhami
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sentovich
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: Kurt
authors.initials: K
authors.lastname: Melstrom
authors.affiliation: May Cho, Chie Akiba, Cecilia Lau, Marwan Fakih, Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA 91010, United States.
authors.forename: Marwan
authors.initials: M
authors.lastname: Fakih
keywords: BRAF; Carcinoembryonic antigen; Pattern of metastatic disease; RAS; Surveillance