Exploring survival outcomes in metastatic colorectal cancer harboring KRAS A146 mutations: Important distinction or simple distraction?

Abstract

Erve et al report an intriguing new prognostic association of KRAS-A146 mutations in metastatic colorectal cancer in their analysis of a cohort of patients with liver metastases, including 12 with the KRAS-A146 mutation. They reported a marked reduction in overall survival (median 10.7 v 26.4 months; hazard ratio = 2.5; P = .003), which was associated with an increased bulk of disease as measured by circulating tumor DNA and radiologically assessed total tumor volume. In the absence of previous reports documenting a major impact of other KRAS mutations, we further explored the impact of KRAS-A146 by analyzing data from a large multisite registry and were unable to reproduce the association reported by Erve et al.