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To identify better regimens in currently available chemotherapy would be beneficial to  KRAS  mutant metastatic colorectal cancer (mCRC) patients because they have fewer treatment options than  KRAS  wild-type mCRC patients. Clinicopathologic features and overall survival (OS) of  KRAS  mutant and wild-type mCRC patients who had used oxaliplatin-based, irinotecan-based, bevacizumab-based, as well as cetuximab-based regimens were compared to those who had never-used oxaliplatin-based, irinotecan-based, bevacizumab-based, as well as cetuximab-based regimens respectively. Between 2007 and 2012, a total of 394 mCRC patients, in whom 169  KRAS  mutant and 225  KRAS  wild-type, were enrolled. In  KRAS  mutant patients who had used oxaliplatin-based regimens (N = 131), the OS was significantly longer than that in  KRAS  mutant patients who had never-used oxaliplatin-based regimens (N = 38). The OS was 28.8 months [95% confidence interval (CI): 23.2–34.4] in  KRAS  mutant patients who had used oxaliplatin-based regimens versus 17.8 months [95% CI: 6.5–29.1] in  KRAS  mutant patients who had never-used oxaliplatin-based regimens (P = 0.026). Notably, OS in  KRAS  wild-type mCRC patients who had used oxaliplatin-based regimens (N = 185) was not significantly longer than that in  KRAS  wild-type mCRC patients who had never-used oxaliplatin-based regimens (N = 40) (P = 0.25). Furthermore, the OS in  KRAS  mutant patients who had used either irinotecan-based, bevacizumab-based or cetuximab-based regimens was not significantly different than that in  KRAS  mutant patients who had never-used either irinotecan-based, bevacizumab-based or cetuximab-based regimens respectively. In multivariate analyses, patients who had used oxaliplatin-based regimens remains an independent prognostic factor for longer OS in  KRAS  mutant mCRC patients. In conclusion, oxaliplatin-based regimens are more beneficial in  KRAS  mutant than in  KRAS  wild-type mCRC patients.

Oxaliplatin-Based Chemotherapy Is More Beneficial in KRAS Mutant than in KRAS Wild-Type Metastatic Colorectal Cancer Patients