IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0107926.html
   My bibliography  Save this article

PCR-Based Assays versus Direct Sequencing for Evaluating the Effect of KRAS Status on Anti-EGFR Treatment Response in Colorectal Cancer Patients: A Systematic Review and Meta-Analysis

Author

Listed:
  • Lianfeng Shan
  • Ming Li
  • Jianzhong Ma
  • Huidan Zhang

Abstract

Background: The survival rate of colorectal cancer (CRC) patients carrying wild-type KRAS is significantly increased by combining anti-EGFR monoclonal antibody (mAb) with standard chemotherapy. However, conflicting data exist in both the wild-type KRAS and mutant KRAS groups, which strongly challenge CRC anti-EGFR treatment. Here we conducted a meta-analysis in an effort to provide more reliable information regarding anti-EGFR treatment in CRC patients. Methods: We searched full reports of randomized clinical trials using Medline, the American Society of Clinical Oncology (ASCO), and the European Society for Medical Oncology (ESMO). Two investigators independently screened the published literature according to our inclusive and exclusive criteria and the relative data were extracted. We used Review Manager 5.2 software to analyze the data. Results: The addition of anti-EGFR mAb to standard chemotherapy significantly improved both progression-free survival (PFS) and median overall survival (mOS) in the wild-type KRAS group; hazard ratios (HRs) for PFS and mOS were 0.70 [95% confidence interval (CI), 0.58–0.84] and 0.83 [95% CI, 0.75–0.91], respectively. In sub-analyses of the wild-type KRAS group, when PCR-based assays are employed, PFS and mOS notably increase: the HRs were 0.74 [95% CI, 0.62–0.88] and 0.87 [95% CI, 0.78–0.96], respectively. In sub-analyses of the mutant KRAS group, neither PCR-based assays nor direct sequencing enhance PFS or mOS. Conclusion: Our data suggest that PCR-based assays with high sensitivity and specificity allow accurate identification of patients with wild-type KRAS and thus increase PFS and mOS. Furthermore, such assays liberate patients with mutant KRAS from unnecessary drug side effects, and provide them an opportunity to receive appropriate treatment. Thus, establishing a precise standard reference test will substantially optimize CRC-targeted therapies.

Suggested Citation

  • Lianfeng Shan & Ming Li & Jianzhong Ma & Huidan Zhang, 2014. "PCR-Based Assays versus Direct Sequencing for Evaluating the Effect of KRAS Status on Anti-EGFR Treatment Response in Colorectal Cancer Patients: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-7, September.
  • Handle: RePEc:plo:pone00:0107926
    DOI: 10.1371/journal.pone.0107926
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0107926
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0107926&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0107926?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Rebecca A. Burrell & Nicholas McGranahan & Jiri Bartek & Charles Swanton, 2013. "The causes and consequences of genetic heterogeneity in cancer evolution," Nature, Nature, vol. 501(7467), pages 338-345, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Humberto Contreras-Trujillo & Jiya Eerdeng & Samir Akre & Du Jiang & Jorge Contreras & Basia Gala & Mary C. Vergel-Rodriguez & Yeachan Lee & Aparna Jorapur & Areen Andreasian & Lisa Harton & Charles S, 2021. "Deciphering intratumoral heterogeneity using integrated clonal tracking and single-cell transcriptome analyses," Nature Communications, Nature, vol. 12(1), pages 1-14, December.
    2. Katherine E. Link & Zane Schnurman & Chris Liu & Young Joon (Fred) Kwon & Lavender Yao Jiang & Mustafa Nasir-Moin & Sean Neifert & Juan Diego Alzate & Kenneth Bernstein & Tanxia Qu & Viola Chen & Euni, 2024. "Longitudinal deep neural networks for assessing metastatic brain cancer on a large open benchmark," Nature Communications, Nature, vol. 15(1), pages 1-10, December.
    3. Johanna Zerbib & Marica Rosaria Ippolito & Yonatan Eliezer & Giuseppina Feudis & Eli Reuveni & Anouk Savir Kadmon & Sara Martin & Sonia Viganò & Gil Leor & James Berstler & Julia Muenzner & Michael Mü, 2024. "Human aneuploid cells depend on the RAF/MEK/ERK pathway for overcoming increased DNA damage," Nature Communications, Nature, vol. 15(1), pages 1-20, December.
    4. Marion Porcherie & Nyan Linn & Anne Roué Le Gall & Marie-Florence Thomas & Emmanuelle Faure & Stéphane Rican & Jean Simos & Nicola Cantoreggi & Zoé Vaillant & Linda Cambon & Jean-Philippe Regnaux, 2021. "Relationship between Urban Green Spaces and Cancer: A Scoping Review," IJERPH, MDPI, vol. 18(4), pages 1-19, February.
    5. Shen Zhao & De-Pin Chen & Tong Fu & Jing-Cheng Yang & Ding Ma & Xiu-Zhi Zhu & Xiang-Xue Wang & Yi-Ping Jiao & Xi Jin & Yi Xiao & Wen-Xuan Xiao & Hu-Yunlong Zhang & Hong Lv & Anant Madabhushi & Wen-Tao, 2023. "Single-cell morphological and topological atlas reveals the ecosystem diversity of human breast cancer," Nature Communications, Nature, vol. 14(1), pages 1-22, December.
    6. Li Chen & Peter L Choyke & Niya Wang & Robert Clarke & Zaver M Bhujwalla & Elizabeth M C Hillman & Ge Wang & Yue Wang, 2014. "Unsupervised Deconvolution of Dynamic Imaging Reveals Intratumor Vascular Heterogeneity and Repopulation Dynamics," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-9, November.
    7. Duncan Ingram & Guy-Bart Stan, 2023. "Modelling genetic stability in engineered cell populations," Nature Communications, Nature, vol. 14(1), pages 1-12, December.
    8. Gunnarsson, Einar Bjarki & Leder, Kevin & Foo, Jasmine, 2021. "Exact site frequency spectra of neutrally evolving tumors: A transition between power laws reveals a signature of cell viability," Theoretical Population Biology, Elsevier, vol. 142(C), pages 67-90.
    9. Jacob C Kimmel & Amy Y Chang & Andrew S Brack & Wallace F Marshall, 2018. "Inferring cell state by quantitative motility analysis reveals a dynamic state system and broken detailed balance," PLOS Computational Biology, Public Library of Science, vol. 14(1), pages 1-29, January.
    10. Nick Henscheid & Eric Clarkson & Kyle J Myers & Harrison H Barrett, 2018. "Physiological random processes in precision cancer therapy," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-25, June.
    11. Richard Newton & Lorenz Wernisch, 2019. "A meta-analysis of multiple matched aCGH/expression cancer datasets reveals regulatory relationships and pathway enrichment of potential oncogenes," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-28, July.
    12. Shiqian Ma & Daniel Johnson & Cody Ashby & Donghai Xiong & Carole L Cramer & Jason H Moore & Shuzhong Zhang & Xiuzhen Huang, 2015. "SPARCoC: A New Framework for Molecular Pattern Discovery and Cancer Gene Identification," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-19, March.
    13. Aleksandr Ianevski & Kristen Nader & Kyriaki Driva & Wojciech Senkowski & Daria Bulanova & Lidia Moyano-Galceran & Tanja Ruokoranta & Heikki Kuusanmäki & Nemo Ikonen & Philipp Sergeev & Markus Vähä-Ko, 2024. "Single-cell transcriptomes identify patient-tailored therapies for selective co-inhibition of cancer clones," Nature Communications, Nature, vol. 15(1), pages 1-16, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0107926. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.