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Background: Absence of KRAS mutations is a predictive factor of response to anti-EGFR agents in the treatment of metastatic colorectal cancer (mCRC) but it does not seem to be associated with Bevacizumab (Bv) treatment’s outcomes. The aim of this study is evaluate response, progression-free survival (PFS) and overall survival (OS) according to KRAS mutational status in patients (pts) with mCRC treated with CT plus Bv. Methods: It has carried out a retrospective study of 46 patients with mCRC who were treated at our institution between January 2004-December 2012 with Bv plus oxaliplatin or irinotecan based CT. PFS and OS times were estimated using Kaplan-Meier. Response Rates (RR) was analyzed with the Fisher’s test. Results: The median age of the patients was 62 years (33-77). 63% were men, and 37% were women. The Bv combination was based in oxaliplatin: 64.8% and based in irinotecan: 25.9%. 9.3% of pts received Bv plus Capecitabine in monotherapy. 75.9% of pts received Bv in first line of treatment. 52% of pts presented KRAS mutations (KRASmut) and 48% presented KRAS wild-type (KRASwt). No statisticallysignificant differences were found between the wild-type group and the mutated group in RR (KRASmut: 75% vs KRASwt: 86.4%; p= 0.445), or in median PFS survival (KRASmut: 12 months (m) (95% CI: 5.4-18.5) vs KRASwt: 10 m (95%CI: 7-13); p= 0.491) or in median OS (KRASmut: 47 m (95%CI: 14.6-65.3) vs KRASwt: 40m (95%CI: 15.8-64.2); p= 0.723). Conclusion: In our experience Bv is an effective treatment in mCRC irrespective of KRAS mutational status, with overall survival rates greater than orequal to 40 m. KRAS mutational status is not predictive of response to Bvor prognostic factor in our series.

Primary tumor location was pancreas in 13 pts (25.5%), lung in 11 pts (21.6%), small or large intestine in 8 pts (15.7%), appendix in 5 pts (9.8%), and other locations in 14 pts (27.5%). Results: Thirty-two pts had low grade (Ki67 20%). 49% (25) of the pts were metastatic at diagnosis. Octreoscan was positive in 15 pts with well-differentiated tumors (low and intermediate grade) and in 3 with poorly differentiated tumors (high grade). Resection of the tumor was possible in 24 pts (75%) with low-grade, three (42.9%) with intermediate and 2 (16.7%) with high grade tumors (Chi squared test, p = 0.002). All high grade NETs were treated with chemotherapy (CT) with cisplatin-etoposide. Only 8 low grade tumors and 5 intermediate grade tumors were treated with CT. Eighteen pts with low grade, 4 with intermediate and 1 with high grade tumor were treated with somatostatin analogues. Median survival was 31.36 months for pts with low grade tumors, 21 months for those with intermediate grade and 14.63 months for high grade tumors, with statistically significant differences (Chi square test, p = 0.002). Conclusion: Grade of differentiation, defined by the expression of cell proliferation marker Ki 67 protein, determines differences in the therapeutic strategy of NETs. Our results coincide with the literature regarding the significant correlation among grade of differentiation and survival in pts with NETs. It is established as the main prognostic factor that also modifies the therapeutic approach.

Background: Bevacizumab has efficacy in first-line treatment of advanced colorectal cancer. The overall response with Bevacizumab is low in some studies. Not know the ideal method of assessing response to therapy with bevacizumab. Metabolic imaging of tumor viability with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET), and simultaneous anatomic localization provided by low-dose non-enhanced computed tomography (CT), can be obtained in a combined modality FDG-PET/CT scan. The purpose of this study was to evaluate the possible contribution of FDG-PET/ CT as a surrogate marker to evaluate treatment response in patients with metastatic colorectal cancer (mCRC) who had been treated with bevacizumab and standard chemotherapy. Methods: Retrospective analysis of 28 patients with advanced colorectal cancer who had been treated in the Hospital Universitario Virgen de las Nieves in Granada. Analyses included all patients who initiated bevacizumab in combination with either first-line oxaliplatin or irinotecan based regimens. FDG-PET/CT scans were performed before the start of the treatment and after six cycles of therapy. Results were compared to concurrent contrast-enhanced CT. Response to treatment was determined according to RECIST size criteria obtained from data from thin (3-5mm) slice CT, and changes in uptake of 18F-FDG uptake on PET. Results: A total of 28 patients were evaluated. Overall, 22 patients had favorable response to treatment, and only 6 had progression of disease. Complete response (CR) was evident on FDG-PET in 6/28 (21,4%) patients whereas only 5 were deemed CR by CT and partial response (PR) in 15/28 (64,3%) with both techniques. Similarly, only 1/ 28 (3,6%) lesion appeared stable by FDG-PET and CT criteria. Progression of disease (PT) was evident on FDG-PET in 6/28 (21,4%) patients whereas only 5 were deemed PT by CT. There was a strong correlation between metabolic response (changes in SUV) and objective response (r = 0.81, P