METASTATİK KOLOREKTAL KANSERLİ HASTALARIN EGFR YA DA VEGF İNHİBİTÖRÜ KULLANIM DURUMLARINA GÖRE KLİNİK ÖZELLİKLERİNİN İNCELENMESİ

AMAÇ: Çalışmada yüksek bir insidansa sahip olan metastatik kolorektal kanser (mKRK) tanılı hastalardaki çeşitli klinik özelliklerin RAS (Rat Sarkom Virüs Geni) mutasyon durumları ve tedavide kullanılan monoklonal antikorlar açısından değerlendirilmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Kesitsel araştırmamız bir onkoloji merkezinde 01.01.2014 - 01.01.2022 dönemini kapsayan retrospektif bir arşiv taraması olarak gerçekleştirilmiştir. Çalışmanın evrenini 18 yaşını doldurmuş, tedavi sürecinde VEGF inhitibitörü (bevasizumab) ya da EGFR inhitibitörü (setuksimab / panitumumab) monoklonal antikor ilaç uygulanan toplam 187 mKRK tanılı hasta oluşturmaktadır. Verilerin toplanmasında hasta arşiv dosyalarından ve hastane bilgi yönetim otomasyon sisteminden yararlanılmıştır. BULGULAR: RAS wild tip bireylerde ikinci en yüksek metastaz görülen organın periton, mutant bireylerde ise akciğer olduğu ve aralarındaki farkın istatistiksel olarak önemli olduğu tespit edilmiştir (p=0,003). Bireylerin tanı aşamasındaki serum karsinoembriyonik antijen (CEA) ve karbonhidrat antijeni 19-9 (CA19-9) seviyelerinin RAS wild tip hastalarda mutant olanlara göre nispeten daha düşük olduğu tespit edilmiştir. RAS wild grupta medyan sağ kalım süresinin 36 ay ve mutant grupta ise 27 ay olduğu saptanmıştır (p=0,001). SONUÇ: Çalışmada RAS mutasyonu varlığının genel sağ kalım süresine negatif yönde etkisi olduğu saptanmıştır. Diğer yandan sağ kalım süresine katkı anlamında monoklonal antikor ilaçlar arasında anlamlı bir fark olmadığı tespit edilmiştir. Ülkemizdeki mKRK’lı hastalarda RAS mutasyonları ile serum tümör biyobelirteçleri seviyeleri arasındaki ilişkilerin daha net ortaya konulabilmesi ve tedavi seçeneklerinin sağ kalım süresine katkıları konusunda çok merkezli ve geniş katılımlı çalışmalara ihtiyaç bulunmaktadır.

Anahtar Kelimeler:

Bevasizumab, Setuksimab, Kolorektal kanser, RAS mutasyonları, Panitumumab

INVESTIGATION OF CLINICAL PROPERTIES OF PATIENTS WITH METASTATIC COLORECTAL CANCER IN TERMS OF EGFR OR VEGF INHIBITORS USAGE

OBJECTIVE: In this study, it was aimed to evaluate some clinical features in patients with metastatic colorectal cancer (mCRC) which have a high incidence, in terms of RAS (Rat Sarcoma Virus Gene) mutation status and monoclonal antibodies used in treatment. MATERIAL AND METHODS: Our cross-sectional study was carried out as a retrospective archive review covering the period between 01.01.2014 and 01.01.2022 in an oncology center. The population of the study consisted of 187 patients who were diagnosed with mCRC, over 18 years of age and administered VEGF inhibitor (bevacizumab) or EGFR inhibitor (cetuximab / panitumumab) monoclonal antibody drugs during the treatment. Patient archive files and hospital information management automation system were used to collect data. RESULTS: It was determined that the second highest metastasis organ was the peritoneum in RAS wild-type individuals, and the lung in mutant individuals, and the difference between them was statistically significant (p=0.003). It was detected that the serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels of individuals at the diagnosis stage were relatively lower in RAS wild-type patients than in mutant ones. The median survival was 36 months in the RAS wild group and 27 months in the mutant group (p=0.001). CONCLUSIONS: In the study, it was determined that the presence of RAS mutation had a negative effect on overall survival. On the other hand, it was determined that there was no significant difference between monoclonal antibody drugs in terms of contribution to survival period. There is a need for multicenter and large-participation studies to reveal the relationship between RAS mutation frequency with tumor biomarkers and to contributions of treatment options to the survival in patients with mCRC more clearly in our country.

Keywords:

Bevacizumab, Cetuximab, Colorectal cancer, RAS mutations, Panitumumab.,

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