THE NECESSITY OF ADVANCED RAS-MUTATIONS INVESTIGATION FOR COLORECTAL CANCER TREATMENT

Retrospective analysis of 3 randomized clinical trials of WT-KRAS metastatic colorectal cancer patients (PRIME, PEAK, FIRE-3) is presented. The PRIME study demonstrated increase in median overall survival (OS) in group receiving panitumumab in addition to FOLFOX4 chemotherapy – 26.0 vs 20.2 months (р = 0.04). The РЕАК trial compared FOLFOX4 + panitumumab and FOLFOX4 + bevacizumab in the same patient group in first-line treatment, a significant increase in median PFS (13.1 vs 9.5 months, p = 0.03) and non-significant increase in median OS (41.3 vs 28.9 months, p = 0.058) was achieved. The FIRE trial demonstrated FOLFIRI + cetuximab superiority when compared to FOLFIRI + bevacizumab in median OS 33.1 vs 25.6 months (р = 0.011). All trials retrospectively analyzed additional RAS mutations, allowing to select a subgroup of patients, who benefit most from EGFR inhibition.