EXPLORING THE PROGNOSTIC VALUE OF COMBINED MSI AND KRAS/BRAF MUTATIONAL STATUS IN COLORECTAL CANCER PATIENTS

Background: Colorectal cancer (CRC) is a significant global health concern, and constant improvement in treatment and prediction is needed. Though resection with adjuvant therapy is the standard for resectable CRC, optimal patient benefit and the development of individualized strategies remain relevant. Microsatellite Instability (MSI) has emerged as a significant molecular marker but requires more definitive clarification of its prognostic interaction with other mutations like BRAF and KRAS. Objective: The objective of this meta-analysis was to comprehensively assess the prognostic value of MSI status, as well as KRAS and BRAF mutations, on overall survival (OS) and progression-free survival (PFS) in patients with CRC after surgical resection. Methods: Systematic literature review was performed, and research was identified on the basis of predefined eligibility criteria. Data for OS, PFS, MSI status, and KRAS/BRAF mutation were gathered. Fixed-effect meta-analysis was conducted to calculate summary HRs and 95% CIs. Risk bias was assessed using standardized tools, and publication bias was tested. Results: The meta-analysis revealed that MSI-high (MSI-H) status was also significantly associated with improved OS (HR: 0.68, 95% CI: 0.60 - 0.77; p