Prognostic Utility Of Transrenal Dna For Colorectal Cancer Patients With Bone Metastases

Purpose: The current study aims to address disease monitoring and prognosis for metastatic colorectal cancer (CRC) patients with bone metastasis using transrenal DNA. Methods: Transrenal DNA was isolated from urine specimens of CRC patients and matched to the tumor tissue profiles to gauge clinical relevance. KRAS mutations were analyzed in these samples. Monitoring of transrenal DNA quantity and KRAS mutations were performed at monthly intervals to track its variations between patients with or without bone metastases. For prognosis assessment, the Cox proportional hazards model was performed for all CRC patients and subsequently on patient subgroups with and without bone metastases. Results: The agreement in KRAS mutations between transrenal DNA and tumor tissues in CRC patients was more than 90%. Transrenal DNA quantities were significantly higher in CRC patients with bone metastases. In this patient cohort, quantities of transrenal DNA increased 2.58 folds during subsequent monitoring. Prognosis was poor for CRC patients who had bone metastases and higher transrenal DNA quantities. Hazard ratio was determined to be 2.11 (95% CI 1.58 to 4.04). Conclusion: Taken together, this demonstrated the usefulness of transrenal DNA for disease monitoring and prognosis of CRC patients with bone metastases. Our results showed that transrenal DNA carries KRAS mutations similar to tumor tissues and its quantity in urine specimen can be potentially useful to identify high-risk patients. This can lead to better disease management or tailored treatment.