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BRAF, PIK3CA, and HER2 Oncogenic Alterations According to KRAS Mutation Status in Advanced Colorectal Cancers with

Soo Kyung Nam1, Sumi Yun1,2, Jiwon Koh2

  • 1Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Plos One
|March 19, 2016
PubMed
Abstract

Insights

In advanced colorectal cancer (CRC), KRAS mutations occur in 54.5% of patients. Identifying PIK3CA, BRAF, and HER2 alterations alongside KRAS status aids in managing advanced CRC.

Area of Science:

  • Oncology
  • Genetics
  • Molecular Biology

Background:

  • Anti-EGFR therapy is crucial for advanced colorectal cancer (CRC).
  • Mechanisms of resistance to anti-EGFR therapy involve KRAS, BRAF, PIK3CA mutations, and HER2 amplification.
  • Understanding the frequency and clinical impact of these genetic alterations is vital for CRC management.

Purpose of the Study:

  • To investigate the frequencies of KRAS, BRAF, PIK3CA mutations, and HER2 amplification in advanced CRC.
  • To determine the clinical implications of these genetic alterations.
  • To evaluate the association between these mutations/amplifications and patient prognosis.

Main Methods:

  • Genotyping of KRAS, BRAF, and PIK3CA mutations using real-time PCR and Sanger sequencing.
  • Assessment of microsatellite instability (MSI) and HER2 amplification via fragmentation assay and silver in situ hybridization, respectively.
  • Analysis of 191 advanced CRC patients with distant metastasis.

Main Results:

  • KRAS mutations were identified in 54.5% of patients, PIK3CA in 13.1%, BRAF in 3.1%, and HER2 amplification in 8.4%.
  • PIK3CA mutations were more common in KRAS-mutant CRC (18.3%) than KRAS wild-type (6.9%).
  • BRAF mutations or HER2 amplifications in KRAS wild-type patients correlated with a worse prognosis (P=0.004).

Conclusions:

  • KRAS mutations are prevalent in 54.5% of advanced CRC cases.
  • Subgrouping patients based on PIK3CA, BRAF, and HER2 status, in addition to KRAS, improves management strategies for advanced CRC.
  • These genetic markers are important for predicting treatment response and patient outcomes.

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