Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2017; 23(32): 5913-5924
Published online Aug 28, 2017. doi: 10.3748/wjg.v23.i32.5913
Integrating TYMS, KRAS and BRAF testing in patients with metastatic colorectal cancer
Anastasios Ntavatzikos, Aris Spathis, Paul Patapis, Nikolaos Machairas, George Peros, Stefanos Konstantoudakis, Danai Leventakou, Ioannis G Panayiotides, Petros Karakitsos, Anna Koumarianou
Anastasios Ntavatzikos, Anna Koumarianou, Hematology-Oncology Unit, 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, 12462 Athens, Greece
Aris Spathis, Danai Leventakou, Petros Karakitsos, Department of Cytopathology, National and Kapodistrian University of Athens, Medical School, “ATTIKON” University Hospital, 12462 Athens, Greece
Paul Patapis, Nikolaos Machairas, 3rd Department of Surgery, Medical School, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, 12462 Athens, Greece
George Peros, Department of Surgery, Medical School, National and Kapodistrian University of Athens, Evgenideio Therapeutirio S.A., “I AGIA TRIAS”, 11528 Athens, Greece
Stefanos Konstantoudakis, Ioannis G Panayiotides, 2nd Department of Pathology, University of Athens, Medical School, “ATTIKON” University Hospital, 12462 Athens, Greece
Author contributions: Ntavatzikos A, Spathis A, Patapis P and Koumarianou A collected and analyzed the data; Ntavatzikos A, Spathis A and Koumarianou A drafted the manuscript; Patapis P, Peros G, Panayiotides IG and Karakitsos P provided analytical oversight; Peros G, Machairas N, Panayiotides IG, Karakitsos P and Koumarianou A designed and supervised the study; Ntavatzikos A, Spathis A, Leventakou D, Karakitsos P and Koumarianou A performed the research; Panayiotides IG and Karakitsos P contributed new analytic tools; Spathis A, Konstantoudakis S, Panayiotides IG and Karakitsos P offered technical or material support; Machairas N, Peros G, Panayiotides IG, Karakitsos P and Koumarianou A provided administrative support; all authors revised the manuscript for important intellectual content, and read and approved the final version to be published.
Supported by Kapodistrias, National and Kapodistrian University of Athens, No. 70/3/8006 (Pythagoras II, EPEAEK II, GSRT) and No. 70/3/9114; Spathis A was supported during data collection by No. 70/3/8462 [PENED European Social Fund (75%) and the Greek Ministry of Development-GSRT (25%)].
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board and Ethical Committee of University General Hospital Attikon, Athens, Greece.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Anastasios Ntavatzikos, MD, General Surgeon, Research Scientist, Hematology-Oncology Unit, 4th Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, “ATTIKON” University Hospital, Rimini 1, Haidari, 12462 Athens, Greece. dmaal2@yahoo.gr
Telephone: +30-210-5831687 Fax: +30-210-5326446
Received: April 12, 2017
Peer-review started: April 14, 2017
First decision: June 7, 2017
Revised: June 22, 2017
Accepted: July 22, 2017
Article in press: July 24, 2017
Published online: August 28, 2017
Core Tip

Core tip: The etiology of resistance to new targeted agents and chemotherapy is currently being investigated based upon the patients’ genetic profile in order to develop a prognostic model that could lead to individualized treatment. In this context, we studied the effect of thymidylate synthase (TYMS) polymorphisms that have been described so far, taking into account the presence of KRAS and BRAF mutations in association with the treatment. TYMS 3’ untranslated region polymorphism ins/ins and ins/loss of heterozygosity emerged as an independent factor that increases the risk of both disease progression and death. Regimens that included irinotecan had reduced risk of disease progression and death.