IMR Press / FBL / Volume 27 / Issue 7 / DOI: 10.31083/j.fbl2707213
Open Access Original Research
KRAS Mutation: Characterization and Its Impact on Survival Outcome of Patients with Metastatic Colorectal Cancer
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1 PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, BE1410 Gadong, Brunei Darussalam
2 The Brunei Cancer Center, Pantai Jerudong Specialist Centre, BG3122 Jerudong, Brunei Darussalam
3 National Pathology Department, Raja Isteri Pengiran Anak Saleha Hospital, BA1712 Bandar Seri Begawan, Brunei Darussalam
*Correspondence: (Ya Chee Lim)
These authors contributed equally.
Academic Editor: Anastasios Koulaouzidis
Front. Biosci. (Landmark Ed) 2022, 27(7), 213;
Submitted: 26 September 2021 | Revised: 7 January 2022 | Accepted: 7 January 2022 | Published: 7 July 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Introduction: Colorectal cancer (CRC) is one of the most common cancer types, with rising incidence due to imbalanced lifestyle and dietary habit. Association between CRC cases and KRAS mutation has been established recently. Brunei Darussalam, located within the Borneo island, is of diverse ethnicity which could represent the genome of Southeast Asia population. Our study, for the first time, determined the survival outcome of metastatic colorectal cancer (mCRC) and established the link with KRAS mutation by modelling the population in Brunei Darussalam. Methods: We collected data of 76 metastatic CRC (mCRC) patients undergoing treatment at The Brunei Cancer Centre, the national centre for cancer treatment in Brunei. These patients were diagnosed with Stage 4 CRC between 1 January 2013 and 31 December 2017. Age, gender, ethnicity, date of diagnosis, site of primary tumour, metastatic sites and molecular analysis of KRAS mutation status (either KRAS mutated or KRAS wild-type) of tumour were recorded. The survival outcomes of these mCRC patients were analysed. Results: The end of this study period recorded 73.1% deceased mutant KRAS mCRC patients and 46.0% deceased wild-type KRAS mCRC patients, contributing to death rates of 45.2% and 54.8%, correspondingly. Chi-squared analysis showed a significant difference between the survival outcomes of wild-type KRAS and mutant KRAS mCRC patients (p-value = 0.024). Conclusions: There is a significant difference between the survival outcomes of wild-type KRAS and mutant KRAS mCRC patients in the Brunei population. In addition, we found that mutations in codon 12 of KRAS gene on mutant KRAS mCRC patients have shorter survival median periods than those with mutations within codon 13 of KRAS gene. This is the first study in Brunei Darussalam to analyse both the survival outcomes of mCRC patients and those of mutant KRAS mCRC patients.

colorectal cancer
Fig. 1.
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