RAS mutation

P=N/A, N=34, Not yet recruiting, Tianjin Medical University General Hospital; Tianjin Medical University General Hospital

P4, N=28, Not yet recruiting, The First Affiliated Hospital,Sun Yat-sen University; The First Affiliated Hospital, Sun Yat-sen University

P4, N=40, Not yet recruiting, Anhui Provincial Cancer Hospital; Anhui Provincial Cancer Hospital

P4, N=236, Not yet recruiting, The First Affiliated Hospital,Sun Yat-sen University; The First Affiliated Hospital,Sun Yat-sen University

No history of liver metastases was an independent favorable risk factor for PFS and OS in univariable and multivariable analyses. These findings indicate that liver metastases are associated with inferior survival outcomes in MSS mCRC patients treated with ICI-based therapies, supporting the immunosuppressive role of liver metastases and underscoring the importance of stratifying patients by liver metastasis status to guide patient selection and optimize therapeutic strategies.

P1, N=104, Completed, Royal Marsden NHS Foundation Trust | Active, not recruiting --> Completed | Trial completion date: Jun 2025 --> Oct 2025 | Trial primary completion date: Jun 2025 --> Oct 2025

First-line treatment with tislelizumab plus XELOX and bevacizumab demonstrated a high ORR and a manageable safety profile in patients with MSS/pMMR, RAS-mutant mCRC. This chemo-immunotherapy combination represents a promising strategy and warrants further investigation in a phase III trial.

P1/2, N=266, Recruiting, Beijing Tide Pharmaceutical Co., Ltd

The RASm/TP53w mutation profile was identified as an independent prognostic factor for decreased OS. These findings are expected to contribute to the literature as real-world evidence regarding the prognostic value of different RAS and TP53 mutation combinations in mCRC.

Our findings extend current diagnostic approaches by showing that dual-gene (BRAF and RAS) testing from fresh FNA washouts is technically feasible (≥90% adequacy) and provides high specificity with modest sensitivity for malignancy in indeterminate nodules. In settings lacking comprehensive commercial panels, this low-complexity approach offers a practical adjunct to cytology and imaging for preoperative decision-making.

Genetic interactions based on co-occurring mutations identified cell lines representative of particularly aggressive subtypes of CRC, including concurrent BRAF p.V600 and truncating APC mutations, as well as APC/TP53/RAS triple mutations with double hits of APC. This study provides a resource to guide the selection of cell lines for functional studies of CRC, and detailed mutation data including classifications of pathogenicity, variant allele frequencies and illustrations of the mutation distribution along the length of encoded proteins are included.

We distinguish established markers already in clinical practice, such as RAS and BRAF mutations, HER2 amplification, microsatellite instability/mismatch repair deficiency (MSI/dMMR), and widely investigated molecular alterations including TP53 mutations and immune-checkpoint-related markers, from novel biomarkers with growing translational potential. We also discuss the implementation challenges of these biomarkers in clinical practice, including issues related to validation, standardization, and cost-effectiveness, as well as the multi-modal approach for the development of composite diagnostic panels.