Full
Outline
To study the efficacy of PD-1 monoclonal antibody in treating microsatellite instability-high (MSI-H) colorectal cancer with different Kras gene point mutations.
Clinical data of patients with confirmed MSI-H colorectal cancer combined with Kras mutations were collected. Patients were divided into four groups based on different Kras mutation types: A146T, G12C, G12D, and G12V. Treatment efficacy was evaluated using the RECIST 1.1 criteria. Event-free survival (EFS) was calculated with the first administration of PD-1 monoclonal antibody as the starting point for survival time. The detection results of tumor markers (CEA, CA19-9, and CA72-4) were compared before and after treatment. The incidence of adverse reactions during treatment across groups was statistically analyzed.
The ORR (overall response rate) was highest in the G12V group (33.33%), followed by the G12D group (25.00%), the G12C group (20.00%), and the A146T group (12.50%). The DCR (disease control rate) was highest in the A146T group (100%), followed by the G12D group (91.66%), the G12V group (86.66%), the G12C group (70.00%), no statistically significant differences in ORR and DCR were observed among all groups (P>0.05). The average EFS duration was 19.25±12.19 months in the G12V group, 17.60±10.46 months in the A146T group, 15.36±9.32 months in the G12C group, and 12.15±7.36 months in the G12D group, with no significant differences among the groups (P>0.05). The median EFS duration was 15.12 months in the G12V group, 12.76 months in the A146T group, 10.65 months in the G12C group, and 10.20 months in the G12D group. In the G12V group, the levels of CEA and CA19-9 decreased significantly after treatment (P<0.05). During treatment, patients experienced immune-related adverse reactions such as rash, thyroid dysfunction, elevated transaminases, immune-related pneumonia, colitis, and peripheral neuritis, but no statistically significant differences in the incidence rates were found among the groups (P>0.05).
PD-1 monoclonal antibody showed better efficacy in patients with MSI-H colorectal cancer combined with Kras G12V mutation.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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