The role of KRAS and BRAF gene mutations as predictive factors in the treatment of locally advanced rectal cancer

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Abstract

BACKGROUND: Molecular genetic studies in the treatment of rectal cancer focus on identifying specific genetic mutations and associated alterations.

AIM: The study aimed to investigate the relationship between KRAS and BRAF gene mutations and tumor response to preoperative chemoradiotherapy in patients with rectal cancer.

METHODS: A total of 65 patients with locally advanced rectal cancer were enrolled in the study, including 31 women and 34 men with a mean age of 54 ± 6.9 years. All patients underwent a course of prolonged neoadjuvant chemoradiotherapy. The patients were categorized into three clinical groups based on tumor regression. Group 1 included 16 (24.6%) patients with minimal response (TRG 0–1), group 2 included 34 (52.3%) patients with partial tumor regression (TRG 2–3), and group 3 comprised 15 (23.1%) patients with complete pathomorphological response (TRG 4). Pearson’s χ² test was employed for statistical analysis using IBM SPSS Statistics 20 software, and cross-tabulations were generated.

RESULTS: A mutation in the KRAS gene was identified in 17 (26.2%) patients. The distribution of patients with this mutation among the clinical groups was as follows: six (37.5%) patients in group 1, eight (23.5%) patients in group 2, and three (20%) patients in group 3. A BRAF mutation was identified in nine (13.9%) patients, including seven (43.8%) and two (13.5%) patients in groups 1 and 3, respectively, whereas no BRAF mutations were found in group 2.

CONCLUSION: The study of the frequency of KRAS and BRAF gene mutations in patients with rectal cancer in various clinical groups showed that the group with low sensitivity to neoadjuvant therapy exhibited a higher frequency of BRAF mutations (χ² (2) = 16.688; p = 0.001; w = 0.52). This may suggest a potential association between this mutation and radioresistance in rectal cancer patients.

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About the authors

Yusif R. Aliyarov

National Oncology Center

Author for correspondence.
Email: yusifaliyarov@yahoo.com
ORCID iD: 0000-0003-2213-9938

MD, Cand. Sci. (Med.), head of oncocoloproctology depart.

Azerbaijan, Baku

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