ArticleFrontiers in immunology2026
RAS mutation status and immune microenvironment define distinct prognostic landscapes and predict chemotherapy benefit in pMMR colorectal cancer.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The aim of this study was to define the interplay between K/N-RAS mutational status, tumor immune microenvironment (TIME), and chemotherapy response in patients with proficient mismatch repair (pMMR) colorectal cancer (CRC)-a population refractory to immunotherapy but constituting >90% of CRC cases. Methods: We retrospectively analyzed 225 patients with pMMR CRC. Multiplex immunohistochemistry was used to quantify stromal and intraepithelial densities of CD4 Results: K/N-RAS status stratified pMMR CRC into two distinct subtypes. In RAS wild-type tumors, high stromal CD4 Conclusions: RAS mutational status shapes a divergent immune landscape that dictates both prognosis and chemotherapy response in pMMR CRC. Integration of RAS status with key TIME features-particularly CD163-may enable the precise selection of patients most likely to benefit from chemotherapy.
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