Long-Survivors with Lung Metastases and Kras Mutations Have an Increased Risk to Develop Brain Metastases From Colorectal Cancer

Zoratto, Federica; Loupakis, Fotios; Cremolini, Chiara; Salvatore, Lisa; Schirripa, Marta; Antoniotti, Carlotta; Marmorino, Federica; Campennì, Giuseppe; Bergamo, Francesca; Zagonel, Vittorina; Tomao, Silverio; Cortesi, Enrico; Allegrini, Giacomo; Lucchesi, Sara; Morvillo, Manfredi; Savi, Roberta; Marcucci, Lorenzo; Minuti, Gabriele; Falcone, Alfredo

doi:10.1093/annonc/mdt201.10

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“…On average, BM occurs 24 to 32 months after the first diagnosis of CRC, 4,9 but increasing time intervals between first CRC diagnosis and diagnosis of BM are observed also attributing this to constantly improving therapies 10 . The presence of lung metastasis as well as a (K)RAS mutation in the tumor tissue is described as independent predictive factors for BM in CRC patients 11‐14 …”

Section: Introductionmentioning

confidence: 99%

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Patients with colorectal cancer and brain metastasis: The relevance of extracranial metastatic patterns predicting time intervals to first occurrence of intracranial metastasis and survival

Thurmaier

Heinemann

Engel

et al. 2020

Intl Journal of Cancer

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The aim of the study was to investigate the predictive impact of extracranial metastatic patterns on course of disease and survival in patients with colorectal cancer (CRC) and brain metastasis (BM). A total of 228 patients (134 male [59%], 94 female [41%]) with histologically proven CRC and BM were classified into different groups according to extracranial metastatic patterns. Time intervals to metastatic events and survival times from initial CRC diagnosis, extracranial and intracranial metastasis were analyzed. Extracranial organs mostly affected were liver (102 of 228 [44.7%]) and lung (96 of 228 [42.1%]). Liver and lung metastases were detected in 31 patients (13.6%). Calculated over the entire course of disease, patients with lung metastasis showed longer overall survival (OS) than patients with liver metastasis or patients without lung metastasis (43.9 vs 34.6 [P = .002] vs 35.0 months [P = .002]). From the date of initial CRC diagnosis, lung metastasis occurred later in CRC history than liver metastasis (24.3 vs 7.5 months). Once lung metastasis was diagnosed, BM occurred faster than in patients with liver metastasis (15.8 vs 26.0 months; Δ 10.2 months). Accordingly, OS from the diagnosis of liver metastasis was longer than from lung metastasis (27.1 vs 19.6 months [P = .08]). Once BM was present, patients with lung metastasis lived longer than patients with liver metastasis (3.8 vs 1.1 months [P = .028]). Shortest survival times in all survival categories analyzed revealed patients with concurrent liver and lung metastasis. Patients with CRC and BM form a heterogeneous cohort where extracranial metastasis to liver or lungs predicts survival.

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Section: Introductionmentioning

confidence: 99%

“…10 The presence of lung metastasis as well as a (K) RAS mutation in the tumor tissue is described as independent predictive factors for BM in CRC patients. [11][12][13][14] The majority of CRC patients develop BM when EM is already present. Thus, BM heralds the final metastatic step of colorectal disease.…”

Section: Introductionmentioning

confidence: 99%