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BRAF Mutations in Advanced Cancers Clinical Characteristics and Outcomes 英文参考文献
BRAFMutationsinAdvancedCancers:Clinical
CharacteristicsandOutcomes
HazemEl-Osta1,GeraldFalchook1,ApostoliaTsimberidou1,DavidHong1,AungNaing1,KevinKim2,
SijinWen3,FilipJanku1,RazelleKurzrock1*
1DepartmentofInvestigationalCancerTherapeutics(PhaseIClinicalTrialsProgram),TheUniversityofTexasMDAndersonCancerCenter,Houston,Texas,UnitedStates
ofAmerica,2DepartmentofMelanomaMedicalOncology,TheUniversityofTexasMDAndersonCancerCenter,Houston,Texas,UnitedStatesofAmerica,3Department
ofBiostatistics,TheUniversityofTexasMDAndersonCancerCenter,Houston,Texas,UnitedStatesofAmerica
Abstract
Background:OncogenicBRAFmutationshavebeenfoundindiversemalignanciesandactivateRAF/MEK/ERKsignaling,a
critical pathway of tumorigenesis. We examined the clinical characteristics and outcomes of patients with mutant (mut)
BRAFadvancedcancerreferredtophase1clinic.
Methods:Wereviewedtherecordsof80consecutivepatientswithmutBRAFadvancedmalignanciesand149withwild-type
(wt)BRAF(matchedbytumortype)referredtotheClinicalCenterforTargetedTherapyandanalyzedtheiroutcome.
Results:Of80patientswithmutBRAFadvancedcancer,56hadmelanoma,10colorectal,11papillarythyroid,2ovarianand
1 esophageal cancer. Mutations in codon 600 were found in 77 patients (62, V600E; 13, V600K; 1, V600R; 1, unreported).
Multivariate analysis showed less soft tissue (Odds ratio (OR)=0.39, 95%CI: 0.20–0.77, P=0.007), lung (OR=0.38, 95%CI:
0.19–0.73, p=0.004) and retroperitoneal metastases (OR=0.34, 95%CI: 0.13–0.86, p=0.024) and more brain metastases
(OR=2.05,95%CI:1.02–4.11,P=0.043)inpatientswithmutBRAFversuswtBRAF.ComparingtothecorrespondingwtBRAF,
mutBRAFmelanomapatientshadinsignificanttrendtolongermediansurvivalfromdiagnosis(131vs.78months,p=0.14),
whilemutBRAF colorectalcancer patientshadaninsignificanttrendtoshorter mediansurvivalfromdiagnosis(48vs.53
months, p=0.22). In melanoma, V600K mutations in comparison to other BRAF mutations were associated with more
frequentbrain(75%vs.36.3%,p=0.02)andlungmetastases(91.6%vs.47.7%,p=0.007),
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