The Prevalence of BRAF, PIK3CA, and RAS Mutations in Indian Patients with Colorectal Cancer

Abstract

Omshree Shetty

Vikas Ostwal

Introduction The present study evaluates the mutation pattern and frequency of BRAF, PIK3CA and RAS in colorectal carcinoma observed in the tertiary cancer center in India.

Materials and Methods Consecutive cases of colorectal adenocarcinoma (n = 330) registered from January 2015 to December 2019 (5-year duration) were selected for the study. Molecular analysis for BRAF.PIK3CA (exon 9 and 20) and RAS (KRAS&NRAS) was performed on representative formalin-fixed paraffin-embedded tissues by Sanger sequencing. Results were correlated with clinicopathological features. Patient overall survival (OS) was obtained using Kaplan–Meier method.

Results The study cohort was in the age range of 22 to 81 years (median age: 52 years) that included 202 males and 96 females (male: female ratio 2.1:1). BRAF V600E mutation was observed in three cases (1%), while 17 cases (5.7%) had mutations in the PIK3CA gene (exon 9 or exon 20). Mutation analysis for RAS gene (KRAS&NRAS) was observed among 42 (15.4%) cases with KRAS mutation and 11 (4%) cases were positive for NRAS mutations. Among RAS, KRAS G12D was the predominant mutation. Median OS with wild-type RAS was 46.6 months (95% confidence interval [CI]: 22.4–70.8), while for RAS mutated patients, it was 25.6 months (95% CI: 16.7–34.5), hazard ratio: 1.7 (95% CI: 1.1–2.7, p = 0.025).

Conclusion This study evaluated the prevalence of BRAF, PIK3CA and RAS mutations in the Indian cohort and its impact on clinical behavior. There was lower incidence of BRAF mutations in this cohort and PIK3CA mutation (single) did not impact survival of the patients.

Keywords

colorectal cancer (CRC) - India - BRAF - PIK3CA - RAS

Author's Contributions

Omshree Shetty and Vikas Ostwal conceptualized and designed the manuscript.

Vikas Ostwal, Anant Ramaswamy, Prabhat Bhargava, Sujay Srinivas, Avanish P Saklani, and Ashwin Desouza were involved in provision of patients.

Omshree Shetty, Vaibhavi, Akhil Kapoor, and Mukta Ramadwar were involved in collection and assembly of data.

Akhil Kapoor, Omshree Shetty, Vaibhavi, Vikas Ostwal, Anant Ramaswamy, Vishakha Kamble, and Mamta Gurav were involved in data analysis and interpretation. All the authors gave final approval of the manuscript and were accountable for all aspects of the work.

Source of Funding

The institution received educational grants from Reddy's Laboratory Private Ltd for the biomarker analysis in this study.

Publikationsverlauf

Artikel online veröffentlicht:
25. April 2022

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