Frequency of KRAS, BRAF, and NRAS mutations in colorectal cancer

Cecily P Vaughn1, Scott D Zobell, Larissa V Furtado

  • 1ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA.

Genes, Chromosomes & Cancer
|February 10, 2011
PubMed

Insights

Mutations in KRAS codons 12/13 are standard for colorectal cancer patients. Testing additional RAS pathway genes like BRAF and NRAS in KRAS wildtype tumors identified resistance mutations in 27.3% of patients.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • Mutational analysis of KRAS codons 12 and 13 is standard for metastatic colorectal cancer (mCRC) patients, predicting response to anti-EGFR therapies.
  • A subset of patients with wildtype KRAS codons 12 and 13 still exhibit resistance to anti-EGFR therapy, suggesting other mutations may be involved.

Purpose of the Study:

  • To determine the frequency of mutations in other RAS pathway genes (KRAS codons 61 and 146, BRAF codon 600, NRAS codons 12, 13, and 61) in mCRC patients wildtype for KRAS codons 12 and 13.
  • To assess the potential role of these additional mutations in resistance to anti-EGFR therapies.

Main Methods:

  • Evaluated 2121 colorectal tumors for mutations in KRAS codons 12 and 13.
  • Utilized targeted pyrosequencing to analyze mutations in KRAS codons 61 and 146, BRAF codon 600, and NRAS codons 12, 13, and 61 in 513 samples wildtype for KRAS codons 12 and 13.

Main Results:

  • Mutations in KRAS codons 12 or 13 were found in 42.4% (900/2121) of samples.
  • In the subset of 513 wildtype samples, 140 (27.3%) harbored mutations in other RAS pathway genes: BRAF (78), KRAS codon 61 (19), KRAS codon 146 (17), and NRAS (26).

Conclusions:

  • A significant proportion (27.3%) of KRAS wildtype mCRC tumors harbor mutations in other RAS pathway genes.
  • Mutational testing of these additional codons may help identify patients resistant to anti-EGFR therapies, warranting further investigation into their therapeutic implications.

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