Impact of KRAS mutation status on outcomes of metastatic colorectal cancer treated with anti-angiogenic agents: a meta-analysis

The impact of KRAS mutation status on outcomes of metastatic colorectal cancer (mCRC) treated with anti-angiogenic agents is controversial. A total of 4,066 mCRC patients from nine randomized controlled trials (RCTs) were included for analysis. The pooled results showed that the use of anti-angiogenic agents significantly improved progression-free survival (PFS) in mCRC patients with KRAS wide type (HR 0.63, 95%CI: 0.53–0.75, p<0.001) or mutated (HR 0.55, 95%CI: 0.38–0.79, p=0.001). In addition, the use of anti-angiogenic agents significantly improved overall survival (OS) in mCRC patients with KRAS wide type (HR 0.78, 95%CI: 0.70–0.86, p<0.001) or KRAS mutant status (HR 0.87, 95%CI: 0.77–0.98, p=0.018). No publication bias was detected for OS and PFS in mCRC patients. The findings of this study show that the use of anti-angiogenic agents significantly improved PFS and OS in mCRC independent of K-RAS gene status. KRAS gene status does not significantly influence the activity of antiangiogenic agents.