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Tumor oncogene ( KRAS ) status and risk of venous thrombosis in patients with metastatic colorectal cancer
Author(s) -
Ades S.,
Kumar S.,
Alam M.,
Goodwin A.,
Weckstein D.,
Dugan M.,
Ashikaga T.,
Evans M.,
Verschraegen C.,
Holmes C. E.
Publication year - 2015
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12910
Subject(s) - kras , medicine , colorectal cancer , pulmonary embolism , oncology , incidence (geometry) , bevacizumab , cancer , thrombosis , oncogene , cumulative incidence , cohort , gastroenterology , chemotherapy , physics , cell cycle , optics
Summary Background Patients with metastatic colon cancer ( mCRC ) are at increased risk of venous thromboembolism ( VTE ). Limited preclinical data suggest that the oncogene ( KRAS ) mutational status of the tumor represents a plausible clinical link to systemic hypercoagulability in cancer patients. Objectives To determine if a tumor genetic characteristic, KRAS mutational status, is associated with an increased risk of VTE in patients with mCRC . Patients/methods A retrospective cohort study of patients with mCRC and KRAS test results was conducted at multiple practice sites across New England in the United States. The primary outcome was a VTE event, defined as deep venous thrombosis ( DVT ) and/or pulmonary embolism ( PE ), either 6 months before or at any time after the diagnosis of mCRC . KRAS status (mutated vs. wild type) and other relevant predictors of thrombosis were collected. Results Of 172 histologically confirmed patients with mCRC , 40 developed a VTE (23.3%). Sixty‐five patients (37.8%) had a mutant KRAS status. The incidence of VTE and DVT among patients with mutated KRAS was 32.3 and 23.1%, respectively. The corresponding incidence among patients with wild‐type KRAS was 17.8 and 9.4%. Odd ratios for the association were 2.21 (95% CI , 1.08–4.53) for VTE and 2.62 (95% CI , 1.12–6.12) for DVT , and remained significant despite adjustment for Khorana score and bevacizumab use. Conclusion Tumor mutant KRAS status is associated with an increased risk of VTE in patients with mCRC . The tumor genetic profile may represent a novel and important risk factor for thrombosis in patients with cancer.