Evidence map›Paper›PMID 33002027›Full record

ArticlePloS one2020

KRAS mutation status concordance between the primary tumor and the corresponding metastasis in patients with rectal cancer.

Peter Jo, Markus Bernhardt, Manuel Nietert, Alexander König, Azadeh Azizian, Markus A Schirmer, Marian Grade, Julia Kitz, Kirsten Reuter-Jessen, Michael Ghadimi and 3 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Pan-ERBB Inhibitors Synergize With KRAS Inhibitors in Rectal Cancer.United European gastroenterology journal · 2025
    Article
  4. Article
  5. Biological factors driving colorectal cancer metastasis.World journal of gastrointestinal oncology · 2024
    Review
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Peter JoDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.ORCID 0000-0002-1552-7150
Markus BernhardtDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
Manuel NietertDepartment of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany.
Alexander KönigDepartment of Gastroenterology and Gastrointestinal Oncology, University Medical Center Goettingen, Goettingen, Germany.
Azadeh AzizianDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
Markus A SchirmerDepartment of Radiotherapy and Radiation Oncology, University Medical Center Goettingen, Goettingen, Germany.
Marian GradeDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
Julia KitzDepartment of Pathology, University Medical Center Goettingen, Goettingen, Germany.
Kirsten Reuter-JessenDepartment of Pathology, University Medical Center Goettingen, Goettingen, Germany.
Michael GhadimiDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
Philipp StröbelDepartment of Pathology, University Medical Center Goettingen, Goettingen, Germany.
Hans-Ulrich SchildhausDepartment of Pathology, University Medical Center Duisburg-Essen, Essen, Germany.
Jochen GaedckeDepartment of General, Visceral and Pediatric Surgery, University Medical Center Goettingen, Goettingen, Germany.
University of Duisburg-Essen · DEUniversity of Göttingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOncogenic mutation within the KRAS gene represents a negative predictor for treatment response to anti-epidermal growth factor receptor (EGFR) in patients with colorectal cancer. Recently, we have shown no relevant heterogeneity for KRAS mutation status within and between pre- and posttherapeutic samples from the primary tumor in patients with locally advanced rectal cancer. The aim of this study was to evaluate the intertumoral heterogeneity of KRAS mutation status between the primary tumor and the corresponding metastasis or local recurrence in the similar cohort and to evaluate the ideal representative tissue for KRAS mutation testing. MATERIALS AND

methodsKRAS mutation status was analyzed from 47 patients with locally advanced rectal cancer, which were enrolled in the CAO/ARO/AIO-94 or CAO/ARO/AIO-04 trial. Mutations in KRAS codons 12, 13, and 61 were analyzed by using the KRAS RGQ PCR Kit (therascreen® KRAS test). Six patients needed to be excluded due to incomplete follow up data. 11 patients showed a relapse of the disease during the follow up presented by distant metastases or local recurrence. DNA from representative areas of metastatic tissue was obtained from formalin-fixed paraffin-embedded specimens.

resultsThe mean patient age was 64.13 ± 10.64 years. In total, 19 patients showed a KRAS mutation (46.34%) in the primary tumor. Of the eleven patients with a metastatic disease or local recurrence, five patients showed a KRAS mutation whereas six patients had a KRAS wildtype status. Metastatic localizations included the liver (n = 2), lung (n = 4), local recurrence (n = 1), liver + lung (n = 3), lung + local recurrence (n = 1). For these eleven patients with paired data available for the primary tumor and metastatic tissue, a significant KRAS mutation status concordance was detected in 81.18% (9/11) of the patients (p = 0.03271). Only two patients showed intertumoral heterogeneity, which harbored in one patient a KRAS G12C mutation status in the primary tumor, but a G12V KRAS mutation status in the corresponding lung lesion, and in the other patient a G12A mutation in the primary lesion and a WT in the lung metastasis.

conclusionsWe show a significant concordance of the KRAS mutation status between tumor samples obtained from the primary tumor and the corresponding metastasis and/ or local recurrence in patients with rectal cancer indicating no relevant intertumoral heterogeneity. Our data suggest that sampling either the primary (pre- or posttherapeutical tumor tissue) or metastatic lesion may be valid for the initial evaluation of KRAS mutation status predicting the response to anti-EGFR treatment and guiding clinical decisions.

Indexed as

Mutation, MissenseAgedFemaleGenetic HeterogeneityHumansMaleMiddle AgedNeoplasm MetastasisNeoplasm Recurrence, LocalProto-Oncogene Proteins p21(ras)Rectal NeoplasmsKRAS protein, humanProto-Oncogene Proteins p21(ras)

Identifiers

PMID33002027
PMCPMC7529221
OpenAlexW3089905444

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.