Molecular Spectrum of K-RAS Mutations in Colorectal Cancer Patients in Peshawar, Pakistan

Background: The global incidence of colorectal cancer (CRC) has surged, presenting a significant health challenge with an annual occurrence of 1.7 million cases. The American Cancer Society reports that KRAS and BRAF mutations contribute to 20-50% of CRC cases. This study addresses the gap in data on KRAS mutations in CRC patients in Peshawar, Pakistan. Objective: To determine the prevalence and types of KRAS mutations in colorectal cancer patients in Peshawar, Pakistan. Methods: This retrospective, cross-sectional study was conducted at the Nuclear Medicine, Oncology, and Radiotherapy Institute (NORI) Hospital in Islamabad from April to November 2022. DNA was extracted from formalin-fixed, paraffin-embedded tissue blocks of 58 CRC patients, regardless of age and gender, following informed verbal consent. KRAS mutation testing was performed using the Cobas Z480 Real-time thermal cycler. Results: Among the 58 CRC patients, 34 (58.6%) were females, and 24 (41.4%) were males. The highest CRC incidence (36.2%) was observed in the 11-25 years age group. KRAS mutations at codons 12 and 13 were found in 18% of cases, with all isolates carrying the G12D mutation. Kaplan-Meier analysis revealed a lower survival probability for patients with codon 12 mutations compared to those with codon 13 mutations. Conclusion: The study highlights the need for broader research on KRAS mutations across diverse ethnicities and geographical regions in Pakistan to better understand CRC prevalence and improve patient outcomes.