SynthesisJournal of the National Cancer Institute2022
KRAS and BRAF Mutations in Stage II and III Colon Cancer: A Systematic Review and Meta-Analysis.
Synthesis in Journal of the National Cancer Institute, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 80 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neoadjuvant Treatment of Fulzerasib Plus Cetuximab N01 in KRAS G12C Mutated Locally Advanced Colorectal Cancer With or Without Resectable Metastases
Neoadjuvant Encorafenib, Cetuximab N01 and mFolfox6 for BRAF V600E Mutated/ pMMR Localized Colorectal Cancer With or Without Resectable Metastases: a Single Arm, Multi-center, Phase 2 Clinical Trial
Who cites it
80 citing papers in PubMed, 7 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Tumor characteristics impact prognosis in deficient mismatch repair/microsatellite instability-high localized colorectal cancer-a systematic review and meta-analysis.JNCI cancer spectrum · 2026Pooled it
- Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2024 for the treatment of colorectal cancer.International journal of clinical oncology · 2025Guideline
- Pooled it
- Defining the Prognostic Significance of BRAF V600E in Early-Stage Colon Cancer: A Systematic Review and Meta-Analysis.Current oncology (Toronto, Ont.) · 2025Pooled it
- Racial disparities in colorectal cancer clinicopathological and molecular tumor characteristics: a systematic review.Cancer causes & control : CCC · 2024Pooled it
- The histological and molecular characteristics of early-onset colorectal cancer: a systematic review and meta-analysis.Frontiers in oncology · 2024Pooled it
- Prognosis of recurrence after complete resection in early-stage lung adenocarcinoma based on molecular alterations: a systematic review and meta-analysis.Scientific reports · 2023Pooled it
- Targeting molecular and genetic pathways driving tumorigenesis for precision therapy in colorectal cancer.Cancer biology & therapy · 2026Review
- Prognostic impact of circulating tumoriScience · 2026Article
- Preoperative Laboratory, Imaging, and Risk Assessment Before Elective Colorectal Cancer Resection: What the Clinician Must Remember.Journal of clinical medicine · 2026Review
- Impact ofCancers · 2026Article
- The Heterogeneity of Mucinous Colorectal Adenocarcinoma-Histologic and Molecular Phenotypes Drive Prognostic Outcomes.Cancers · 2026Article
- Pharmacologic reprogramming of virus-tumor crosstalk enhances measles virus antitumor activity in BRAF mutant colorectal cancer models.Journal of experimental & clinical cancer research : CR · 2026Article
- KRAS and BRAF mutations modify adjuvant chemotherapy outcomes in early stage colorectal cancer.NPJ precision oncology · 2026Article
- Prognostic factors for 5 year relapse-free survivors following curative resection for stage II/III colorectal cancer.Surgery today · 2026Article
- Clusters of Anthropometric Features in Colorectal Cancer Patients with Synchronous Metastases and Their Association with Overall Survival and RAS Mutation.Journal of gastrointestinal cancer · 2026Article
- KRAS Mutation Status as a Prognostic Marker and Predictor of Therapy Response in Colorectal Cancer: an NCDB Analysis.Journal of gastrointestinal cancer · 2026Article
- Clinicopathological characteristics and prognosis of patients with mucinous adenocarcinoma originating from the left colon, right colon, or rectum: a nationwide retrospective study in China.Journal of gastrointestinal oncology · 2026Article
- Spectral CT imaging in colorectal cancer: current applications, limitations, and future perspectives.Insights into imaging · 2026Review
- Sequential changes in conditional survival of patients following surgical resection of colorectal cancer and indicators for follow-up beyond 5 years.International journal of clinical oncology · 2026Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKRAS and BRAF mutations are well-established predictive and prognostic factors in metastatic colorectal cancer; however, their impact in the adjuvant setting has not yet been established.
methodsWe performed a meta-analysis of adjuvant phase III trials in patients with stage II and III colon cancer with available data on the impact of KRAS or BRAF mutations on both disease-free survival (DFS) and overall survival (OS). Trials were subgrouped based on whether adjustment for microsatellite instability (MSI) was performed and the subgroup effect was analyzed through a meta-regression. To increase the precision of the estimates, a joint DFS-OS (so-called "multivariate") meta-analysis was performed. All statistical tests were 2-sided.
resultsNine trials were selected (QUASAR 2, PETACC-8, N0147, CALGB-89803, NSABP-C07, NSABP-C08, PETACC-3, QUASAR, MOSAIC) including a total of 10 893 patients. In the primary meta-analysis, KRAS mutation was associated with poor DFS (pooled hazard ratio [HR] = 1.36, 95% confidence interval [CI] = 1.15 to 1.61, P < .001) and OS (pooled HR = 1.27, 95% CI = 1.03 to 1.55, P = .03) and BRAF mutation was also associated with poor DFS (pooled HR = 1.33, 95% CI = 1.00 to 1.78, P = .05) and OS (pooled HR = 1.49, 95% CI = 1.31 to 1.70, P < .001). The effect of the mutations on outcome was enhanced in the MSI-adjusted subgroup for both the KRAS mutation (pooled HR for DFS = 1.43, 95% CI = 1.15 to 1.79, P = .001; and pooled HR for OS = 1.33, 95% CI = 1.03 to 1.71, P = .03) and the BRAF mutation (pooled HR for DFS = 1.59, 95% CI = 1.22 to 2.07, P = .001; and pooled HR for OS = 1.67, 95% CI = 1.37 to 2.04, P < .001). The interaction between BRAF and MSI adjustment was statistically significant for DFS (Pinteraction = .02). This interaction was even more pronounced in the DFS-OS multivariate meta-analysis.
conclusionsBoth KRAS and BRAF mutations were statistically significantly associated with both DFS and OS, with the mutation effect being enhanced by MSI adjustment. Effective adjuvant treatment for microsatellite-stable BRAF or KRAS-mutated colon cancer represents an unmet clinical need, and exploring the use of recently available BRAF and KRAS inhibitors in this setting would be highly desirable.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.