Impact of p53 Mutational Status and Smoking in Progression-Free Survival in Metastatic Colorectal Cancer

Background: The impact of p53 mutation and smoking on the prognosis of colorectal cancer patients is a topic that continues to be the subject of debate within the scientific community. The objective of this study was to evaluate the impact of various factors, particularly p53 mutation and smoking, on treatment response. Material and methods: All patients diagnosed with metastatic colorectal cancer (mCRC) at an academic center within a specified time interval were included in this study. The potential impact of various factors, particularly p53 and smoking status, on the efficacy of first-line chemotherapy was assessed.. Common clinical features, including p53 status, smoking, metastasis status at diagnosis, MMR, and RAS status, were tested for correlation with outcomes. Univariate and multivariate Cox models were employed to analyze progression-free survival (PFS) associations. Results: A total of 101 newly diagnosed metastatic colorectal cancer (mCRC) patients initiating first-line chemotherapy were included in the study. The median age was 62 years, and 69% of the patients were male. Progression-free survival (PFS) analysis indicated that cumulative smoking (pack-years) and p53 mutation status were associated with treatment outcomes. The overall median PFS (mPFS) was 11.6 months; it was 17.6 months in smokers and 10.7 months in non-smokers.The mPFS was 16.6 months in the p53 mutant group and 10 months in the wild-type group. Discussion: A significant correlation was identified between p53 mutation status and smoking, as well as treatment response, in colorectal cancer patients. Patients with a p53 mutation and a history of smoking exhibited prolonged mPFS.