Hum Antibodies. 2021;29(4):275-284. doi: 10.3233/HAB-210451.
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.
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.
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.
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.
转移性或复发性结直肠癌（MRCRC）预后不良。本荟萃分析的目的是评估转移性 CRC 患者中不同类型 KRAS 突变和 BRAF 突变的流行率，并评估肿瘤侧别与 KRAS 和 BRAF 突变流行率之间的关系。
我们从 2010 年 1 月至 2020 年 7 月，在 MEDLINE/PubMed、Cochrane 图书馆和 ClinicalTrials.gov 上进行了检索。根据系统评价和荟萃分析的首选报告项目（PRISMA），我们独立提取了数据。统计分析使用 STATA 和 Meta-Disk 1.4 应用程序进行。
共有 6699 例结直肠癌患者被纳入。报告了 28%和 6%的患者存在 KRAS 和 BRAF 突变。右原发和左原发转移性 CRC 患者 KRAS 突变的总体流行率分别为 40%和 60%。然而，右原发和左原发转移性 CRC 患者 BRAF 突变的流行率分别为 37%和 63%。转移性 CRC 患者中 KRAS 突变型的总体 HR 为 2.38。我们的研究显示，KRAS 突变型转移性结直肠癌患者的总体平均生存时间为 35.4 个月，BRAF 突变型患者的生存时间为 10.12 个月。
根据肿瘤位置的不同，KRAS 和 BRAF 突变的流行率差异显著。BRAF 突变在右侧转移性结直肠癌中更为常见。肝脏是 KRAS 突变患者转移的最常见部位，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 患者人群，并可能对改善和组织抗 EGFR 治疗具有意义。需要进一步研究以评估通过突变状态和原发肿瘤位置的生存差异。
