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KRAS and BRAF mutations in Iranian colorectal cancer patients: A systematic review and meta-analysis
Abolfazl Yari1,2, Asiyeh Afzali3, Mostafa Aalipour4
1Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran.
Background:
Mutations in the EGFR signaling pathway play an important role in the development of colorectal cancer (CRC). Mutations in these genes, like KRAS and BRAF, affect the treatment strategies and associated with poor prognosis and relative resistance to anti-EGFR therapies. Our aim was to conduct a systematic and meta-analysis on all studies that have been conducted on the prevalence of these gene mutations in Iranian CRC patients.
Methods:
Four science citation index databases (MEDLINE, EMBASE, Web of Science and Cochrane library) and local databases were searched up to March 2018 with related keywords. Two reviewers independently screened and extracted the data. Quality of all included studies was assessed using an adapted checklist from STROBE. A random-effect model was used to calculate the total prevalence of KRAS and BRAF mutations in CRC subjects by the event rate (ER). Meta-regression was utilized to explore heterogeneity causes.
Results:
In total, from 573 records, 23 eligible studies (2662 patients) were included for data extraction and analysis. In 18 of 23 included studies, the prevalence of KRAS mutations was 33.9% (95% CI=30.1-37.9) with I2=65.17 (p<0.001). The occurrence of KRAS mutations in codon 12 and 13 was 76.9% (95% CI = 70.4-82.3%) with I2=84.88 (p<0.001) and 23.5% (95% CI=17.9-30.3) with I2=85.85 (p<0.001), respectively. In 9 of 23 studies, the BRAF mutation rate was 3.2% (95% CI=0.003-13.6) with I2=88.61 (p<0.001).
Conclusion:
The prevalence of these mutations in CRC patients shows a significant difference in the different regions of Iran, which is probably due to environmental and racial factors.
Insights
This meta-analysis found KRAS mutations in 33.9% and BRAF mutations in 3.2% of Iranian colorectal cancer (CRC) patients. These gene mutations significantly impact CRC treatment strategies and patient prognosis.
Area of Science:
- Oncology
- Genetics
- Epidemiology
Background:
- Mutations in the Epidermal Growth Factor Receptor (EGFR) signaling pathway are crucial in colorectal cancer (CRC) development.
- KRAS and BRAF gene mutations influence CRC treatment, prognosis, and resistance to anti-EGFR therapies.
Purpose of the Study:
- To systematically analyze and meta-analyze the prevalence of KRAS and BRAF gene mutations in Iranian CRC patients.
- To provide a comprehensive overview of mutation frequencies in this specific population.
Main Methods:
- A systematic search of four major databases (MEDLINE, EMBASE, Web of Science, Cochrane) and local Iranian databases up to March 2018.
- Data extraction and quality assessment by two independent reviewers, with meta-regression used to explore heterogeneity.
Main Results:
- Included 23 studies with 2662 CRC patients.
- Prevalence of KRAS mutations was 33.9% (codon 12 and 13: 76.9% and 23.5% respectively).
- BRAF mutation rate was 3.2%.
Conclusions:
- Significant regional variations in mutation prevalence across Iran suggest environmental and racial factors.
- Understanding these mutation frequencies is vital for tailoring CRC treatment in Iran.
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