KRAS and Two Rare PI3KCA Mutations Coexisting in a Metastatic Colorectal Cancer Patient With Aggressive and Resistant Disease

We describe a metastatic colorectal cancer (mCRC) patient, treated with first-line FIr-B/FOx (5-fluorouracil, irinotecan, bevacizumab, oxaliplatin) therapy, with aggressive and resistant disease. KRAS, NRAS, BRAF, PI3KCA were analyzed in primary tumor and liver metastasis. KRAS c.34G>A mutation was detected in primary tumor and liver metastasis, which, additionally, revealed two rare PI3KCA mutations (c.1633G>C, c.1645G>C). The c.1645G>C was never reported in CRC. Akt/p-AktSer473, PTEN, mismatch repair (MMR), epidermal growth factor receptor (EGFR) expression was evaluated.

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