Effect of KRAS and BRAF mutations in metastatic colorectal cancer patients: A systematic review and meta-analysis based on tumor sidedness and KRAS subtypes.

Q3 Medicine
Khadijeh Saravani, Morteza Salarzaei, Fateme Parooie
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引用次数: 6

Abstract

Introduction: Metastatic or recurrent colorectal cancer (MRCRC) has a poor prognosis. The aim of the present meta-analysis was to assess the prevalence of different subtypes of KRAS mutation and BRAF mutation in metastatic CRC patients, and evaluate the relationship between the tumor sidedness and prevalence of KRAS and BRAF mutation.

Methods: We searched MEDLINE/PubMed, the Cochrane Library, and ClinicalTrials.gov from January 2010 to July 2020. The data were extracted independently according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The statistical analysis was done using STATA and Meta-Disk 1.4 applications.

Results: Overall, 6699 colorectal cancer patients were included. KRAS and BRAF mutation was reported in 28% and 6% of patients, respectively. The overall prevalence of right primary and left primary metastatic CRC patients with mutated KRAS was 40% and 60%. However, the prevalence BRAF mutated right primary and left primary metastatic CRC patients was 37% and 63%. The overall HR was 2.38 for patients with metastatic CRC who had a mutated type of KRAS. Our study showed a mean overall survival of 35.4 month for KRAS mutant and a 10.12 month survival for BRAF mutant patients with metastatic colorectal cancer patients.

Conclusion: The prevalence of KRAS and BRAF mutations varied significantly according to the location of the tumor. BRAF mutations are more commonly found in metastatic colorectal cancers on the right side. Liver was the most common site of metastases in patients with mutant KRAS and the mortality of patients with mutant KRAS was 2.3 times higher than the patients with wild types. These results help to better describe the population of mCRC patients and can have implications for improving and organizing anti-EGFR therapies. Further research is needed to assess differences in survival through mutation status and primary tumor location.

KRAS和BRAF突变对转移性结直肠癌患者的影响:基于肿瘤侧边性和KRAS亚型的系统回顾和荟萃分析
转移性或复发性结直肠癌(MRCRC)预后较差。本meta分析的目的是评估转移性结直肠癌患者中不同亚型KRAS突变和BRAF突变的患病率,并评估肿瘤的侧边性与KRAS和BRAF突变患病率之间的关系。方法:检索2010年1月至2020年7月的MEDLINE/PubMed、Cochrane图书馆和ClinicalTrials.gov。根据系统评价和荟萃分析首选报告项目(PRISMA)独立提取数据。使用STATA和Meta-Disk 1.4应用程序进行统计分析。结果:共纳入6699例结直肠癌患者。KRAS和BRAF突变分别在28%和6%的患者中报道。KRAS突变的右原发和左原发转移性结直肠癌患者的总体患病率分别为40%和60%。然而,BRAF突变的右侧原发性和左侧原发性转移性CRC患者的患病率分别为37%和63%。KRAS突变型转移性结直肠癌患者的总HR为2.38。我们的研究显示KRAS突变体患者的平均总生存期为35.4个月,BRAF突变体患者合并转移性结直肠癌患者的平均总生存期为10.12个月。结论:KRAS和BRAF突变的发生率因肿瘤部位的不同而有显著差异。BRAF突变更常见于右侧转移性结直肠癌。肝脏是突变型KRAS患者最常见的转移部位,突变型KRAS患者的死亡率是野生型患者的2.3倍。这些结果有助于更好地描述mCRC患者群体,并可能对改善和组织抗egfr治疗具有指导意义。需要进一步的研究来评估通过突变状态和原发肿瘤位置的生存差异。
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来源期刊
Human Antibodies
Human Antibodies Medicine-Immunology and Allergy
CiteScore
3.50
自引率
0.00%
发文量
27
期刊介绍: Human Antibodies is an international journal designed to bring together all aspects of human hybridomas and antibody technology under a single, cohesive theme. This includes fundamental research, applied science and clinical applications. Emphasis in the published articles is on antisera, monoclonal antibodies, fusion partners, EBV transformation, transfections, in vitro immunization, defined antigens, tissue reactivity, scale-up production, chimeric antibodies, autoimmunity, natural antibodies/immune response, anti-idiotypes, and hybridomas secreting interesting growth factors. Immunoregulatory molecules, including T cell hybridomas, will also be featured.
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