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‹ Thu · 21 May 2026
Promising but preliminary

Plasma Biomarkers Associated with Clinical Outcomes of FOLFIRI Plus Ramucirumab in RAS Wild-Type Metastatic Colorectal Cancer: The JACCRO CC-16AR Trial

Hidden mutations detectable in blood predict treatment failure in colorectal cancer patients, suggesting which patients need different drug combinations from the start.

In RAS wild-type mCRC patients, pre-treatment ctDNA reveals emergent RAS mutations in 44% of cases, which confer dramatically worse OS on FOLFIRI+ramucirumab and correlate with elevated IL-8 suggesting an inflammatory-resistance axis. These findings have direct implications for patient selection and combination therapy strategies in second-line mCRC.

What the study was

Study design
Translational biomarker substudy embedded in a clinical trial (JACCRO CC-16)
Population
RAS wild-type metastatic colorectal cancer patients receiving FOLFIRI+ramucirumab after prior anti-EGFR therapy (n=41 evaluable)
Sample size
41
Category
Genomics/Precision Medicine
Maturity
Exploratory
Journal
Targeted Oncology

Why it surfaced

Important biomarker finding in mCRC second-line therapy; RAS clonal evolution detected by ctDNA in 44% despite wild-type tissue; n=41 limits confidence; multi-center Japanese trial adds real-world validity.

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