1. Prognostic value of KRAS codon 13 gene mutation for overall survival in colorectal cancer: Direct and indirect comparison meta-analysis
- Author
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Joung Il Lee, Min Seob Kwak, Jae Myung Cha, Jung Won Jeon, Hyung Kyung Kim, Jin Young Yoon, Hyejung Chang, Kwang Ro Joo, and Hyun Phil Shin
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Colorectal cancer ,Subgroup analysis ,colorectal cancer ,Gene mutation ,medicine.disease_cause ,Proto-Oncogene Proteins p21(ras) ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,KRAS ,Medicine ,Humans ,Clinical significance ,Codon ,neoplasms ,business.industry ,Hazard ratio ,General Medicine ,medicine.disease ,Prognosis ,digestive system diseases ,ErbB Receptors ,meta-analysis ,030104 developmental biology ,030220 oncology & carcinogenesis ,Meta-analysis ,Mutation (genetic algorithm) ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,codon 13 mutation ,business ,Colorectal Neoplasms ,Systematic Review and Meta-Analysis ,Research Article - Abstract
Supplemental Digital Content is available in the text, Background: The clinical significance of KRAS codon 13 mutation in patients with colorectal cancer (CRC) remains controversial. A systematic review and meta-analysis is necessary for a more precise estimation of the predictive role of KRAS codon 13 mutations in CRC patients. Methods: We performed a systematic search using the MEDLINE, EMBASE, and Cochrane library databases from January 2000 to November 2016. The prognostic value of KRAS codon 13 mutation for overall survival (OS) was investigated by measuring the hazard ratio (HR) and 95% confidence interval (CI). Data were analyzed with Review Manager Version 5.3 and the Canadian Agency for Drugs and Technologies in Health software. Results: OS in CRC patients with KRAS codon 13 mutation was worse than that in CRC patients with KRAS wild-type (pooled HR = 1.37, 95% CI: 1.03–1.81, P = .03). Subgroup analysis of studies of enrolled CRC patients treated with antiepidermal growth factor receptor (EGFR) therapy showed no significant difference in OS associated with KRAS codon 13 mutation in comparison to KRAS wild-type (pooled HR = 1.57, 95% CI: 0.98–2.51, P = .06). In the indirect comparison, no statistically significant association was observed between codon 12 and 13 mutations for OS in CRC patients (pooled HR = 0.88, 95% CI: 0.65–1.20, P = .43). Conclusion: The current meta-analysis suggests that Codon 13 mutation of KRAS gene seems to correlate with the OS of patients with CRC, but has similar OS to those with KRAS wild-type in patients receiving anti-EGFR therapy. No difference was detected in the OS of CRC patients with codon 13 mutation versus codon 12 mutation.
- Published
- 2017