RESUMO
BACKGROUND: Current metastatic colorectal cancer (mCRC) therapy uses monoclonal antibodies against the epidermal growth factor receptor. This treatment is only useful in the absence of K-RAS gene mutations; therefore the study of such mutations is part of a personalized treatment. The aim of this work is to determine the frequency and type of the most common K-RAS mutations in Mexican patients with metastatic disease by nucleotide sequencing. PATIENTS AND METHODS: We studied 888 patients with mCRC from different regions of Mexico. The presence of mutations in exon 2, codons 12 and 13, of the K-RAS gene was determined by nucleotide sequencing. RESULTS: Patients exhibited K-RAS gene mutations in 35% (310/888) of cases. Mutation frequency of codons 12 and 13 was 71% (221/310) and 29% (89/310), respectively. The most common mutation (45.7%) in codon 12 was c.35G>A (p.G12D), whereas the one in codon 13 was c.38G>A (p.G13D) (78.7%). DISCUSSION: Given the frequency of K-RAS mutations in Mexicans, making a genetic study before deciding to treat mCRC patients with monoclonal antibodies is indispensable.
Assuntos
Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , DNA de Neoplasias/análise , Proteínas Proto-Oncogênicas p21(ras)/genética , Antineoplásicos/uso terapêutico , Bevacizumab/uso terapêutico , Cetuximab/uso terapêutico , Códon , Neoplasias Colorretais/patologia , Análise Mutacional de DNA , Éxons , Feminino , Humanos , Masculino , México , Taxa de Mutação , Metástase Neoplásica , Medicina de PrecisãoRESUMO
PURPOSE: In this study we evaluated the activity and toxicity of a combination of 5-fluorouracil continuous infusion and vinorelbine as second or third line chemotherapy in metastatic breast cancer (MBC). PATIENTS AN METHODS: A total 24 patients who had received doxorrubicin and/or paclitaxel were included in this study. The regimen consisted in 5-fluorouracil 1 gr/m(2) BSA continuous infusion for 3 days and vinorelbine 30 mg/m(2) intravenous (IV) on day 1. The cycles were repeated every 21 days for 6 cycles. RESULTS: Objective responses were recorded in 37.5% (12.5% complete remission). The median disease-free survival was calculated 6.33 +/- 8.12 months (CI 95% of 3.43 months). Toxicity was observed in 12.5% of the patients and no treatment related deaths were recorded. CONCLUSION: The combination of 5-fluorouracil/vinorelbine at the dose administered is an effective regime in patients with MBC, with low toxicity and cost.