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Detection of a Circulating MicroRNA Custom Panel in Patients with Metastatic Colorectal Cancer
Published on: March 14, 2019
Microsatellite instability and BRAF mutation testing in colorectal cancer prognostication
Paul Lochhead1, Aya Kuchiba, Yu Imamura
1Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA.
Journal of the National Cancer Institute
|July 24, 2013
Summary
Microsatellite instability (MSI) and BRAF mutations in colorectal cancer impact patient survival. MSI-high/BRAF-wild-type tumors show the best prognosis, while MSS/BRAF-mutant tumors have a worse outlook.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Genetics
Background:
- BRAF mutations are linked to microsatellite instability (MSI) in colorectal cancer (CRC) via CIMP and MLH1 methylation.
- MSI and BRAF analyses are vital for assessing familial cancer risk.
Purpose of the Study:
- To investigate the prognostic significance of combined MSI and BRAF mutation status in CRC.
- To stratify CRC patient survival based on molecular subtypes.
Main Methods:
- Survival analysis of 1253 rectal and colon cancer patients from the Nurses' Health Study and Health Professionals Follow-up Study.
- Assessment of MSI, BRAF, CIMP, LINE-1 hypomethylation, KRAS, and PIK3CA mutations.
Main Results:
- Compared to MSS/BRAF-wild-type, MSS/BRAF-mutant tumors had a hazard ratio (HR) of 1.60 (P=.009).
- MSI-high/BRAF-mutant tumors had an HR of 0.48 (P=.02).
- MSI-high/BRAF-wild-type tumors showed the best prognosis with an HR of 0.25 (P<.001). No significant interaction between BRAF and MSI was observed.
Conclusions:
- Combined BRAF/MSI status serves as a crucial molecular biomarker for prognostic risk stratification in colorectal cancer.
- This stratification can inform clinical decision-making and patient management.
