Genomic characterization and clinical outcomes of patients with peritoneal metastases from the AACR GENIE biopharma collaborative colorectal cancer registry Journal Article


Authors: Sanz-Garcia, E.; Brown, S.; Lavery, J. A.; Weiss, J.; Fuchs, H. E.; Newcomb, A.; Postle, A.; Warner, J. L.; LeNoue-Newton, M. L.; Sweeney, S. M.; Pillai, S.; Yu, C.; Nichols, C.; Mastrogiacomo, B.; Kundra, R.; Schultz, N.; Kehl, K. L.; Riely, G. J.; Schrag, D.; Govindarajan, A.; Panageas, K. S.; Bedard, P. L.
Article Title: Genomic characterization and clinical outcomes of patients with peritoneal metastases from the AACR GENIE biopharma collaborative colorectal cancer registry
Abstract: Peritoneal metastases (PM) are common in metastatic colorectal cancer (mCRC). We aimed to characterize patients with mCRC and PM from a clinical and molecular perspective using the American Association of Cancer Research Genomics Evidence Neoplasia Information Exchange (GENIE) Biopharma Collaborative (BPC) registry. Patients' tumor samples underwent targeted next-generation sequencing. Clinical characteristics and treatment outcomes were collected retrospectively. Overall survival (OS) from advanced disease and progression-free survival (PFS) from start of cancer-directed drug regimen were estimated and adjusted for the left truncation bias. A total of 1,281 patients were analyzed, 244 (19%) had PM at time of advanced disease. PM were associated with female sex [OR: 1.67; 95% confidence interval (CI): 1.11-2.54; P = 0.014] and higher histologic grade (OR: 1.72; 95% CI: 1.08-2.71; P = 0.022), while rectal primary tumors were less frequent in patients with PM (OR: 0.51; 95% CI: 0.29-0.88; P < 0.001). APC occurred less frequently in patients with PM (N = 151, 64% vs. N = 788, 79%) while MED12 alterations occurred more frequently in patients with PM (N = 20, 10% vs. N = 32, 4%); differences in MED12 were not significant when restricting to oncogenic and likely oncogenic variants according to OncoKB. Patients with PM had worse OS (HR: 1.45; 95% CI: 1.16-1.81) after adjustment for independently significant clinical and genomic predictors. PFS from initiation of first-line treatment did not differ by presence of PM. In conclusion, PM were more frequent in females and right-sided primary tumors. Differences in frequencies of MED12 and APC alterations were identified between patients with and without PM. PM were associated with shorter OS but not with PFS from first-line treatment. Significance: Utilizing the GENIE BPC registry, this study found that PM in patients with colorectal cancer occur more frequently in females and right-sided primary tumors and are associated with worse OS. In addition, we found a lower frequency of APC alterations and a higher frequency in MED12 alterations in patients with PM.
Keywords: survival; mutation; chemotherapy; carcinomatosis; impact; patterns; trials; hipec
Journal Title: Cancer Research Communications
Volume: 4
Issue: 2
ISSN: 2767-9764
Publisher: American Association for Cancer Research  
Date Published: 2024-02-01
Start Page: 475
End Page: 486
Language: English
ACCESSION: WOS:001181811300008
DOI: 10.1158/2767-9764.Crc-23-0409
PROVIDER: wos
PMCID: PMC10876516
PUBMED: 38329392
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Source: Wos
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MSK Authors
  1. Deborah Schrag
    229 Schrag
  2. Gregory J Riely
    599 Riely
  3. Katherine S Panageas
    512 Panageas
  4. Nikolaus D Schultz
    486 Schultz
  5. Ritika   Kundra
    88 Kundra
  6. Jessica Ann Lavery
    79 Lavery
  7. Samantha Brown
    56 Brown
  8. Chelsea Lynn Nichols
    15 Nichols
  9. Shirin Ajay Pillai
    4 Pillai
  10. Hannah Fuchs
    7 Fuchs