SPECTRUM OF BRAF MUTATIONS IN PAKISTANI COHORT

MOTIVATION BEHIND THE STUDY "BRAF mutations and the association of V600E with CD133 and CDX2 expression in a Pakistani colorectal carcinoma cohort " https://doi.org/10.1186/s12885-024-12925-z

Published in Cancer and Biomedical Research

Like

Share this post

Choose a social network to share with, or copy the URL to share elsewhere

This is a representation of how your post may appear on social media. The actual post will vary between social networks

Explore the Research

BioMed Central
BioMed Central BioMed Central

BRAF mutations and the association of V600E with CD133 and CDX2 expression in a Pakistani colorectal carcinoma cohort - BMC Cancer

Background Despite a high incidence of colorectal carcinoma, data regarding genetic aberrations in colorectal carcinoma (CRC) patients in Pakistan is scarce. This study aimed to determine the frequency of BRAFV600E mutations in colorectal carcinoma tissue in the Pakistani population and to associate BRAFV600E expression with CD133, a marker of colorectal stem cells, and CDX2 marker of differentiation. Methods Sanger Sequencing of exon 15 (426 bp) including the hotspot V600E was performed on formalin-fixed-paraffin-embedded (FFPE) CRC tissue samples of 115 patients. The samples were subjected to immunohistochemistry (IHC) to assess the expression of BRAFV600E, CDX2, and CD133. Additionally, homology modelling and docking were performed to investigate novel deletions revealed in sequencing. Results Twenty-four (20.8%) BRAF variants were identified in the coding region, with V600E mutations detected in 14 (12.2% )cases (GenBank: PP003258.1; Pop Set: 2678087296). Moreover, a wide spectrum of novel non-V600E mutations (8.6%) were identified, including deletions and missense variations. In-silico analysis revealed that due to large deletions in the coding region of three samples, the affinity of the anti-BRAF drugs (Encorafenib and Vemurafenib) for the active site decreased in comparison to the wild type. The IHC analysis showed that BRAFV600E expression was significantly associated with CD133 expression (χ2(1, n=115) = 26.351; p = < 0.001) and with CDX2 expression (χ2(1, n=115) = 14.88; p = 0.001). Multivariate analysis using binary logistic regression revealed association of BRAFV600E mutations with age (OR = 1.123; CI = 1.024–1.232; p = 0.014), gender (OR = 0.071; CI = 0.006–0.831; p = 0.035), grade (0.007; CI = 0-0.644) and CD133 expression (OR = 65.649; CI = 2.153-2001.556; p = 0.016). Conclusion The present study demonstrates a notably high V600E frequency (12.2%) in comparison to global reported data, which ranges from 0.4 to 18%. This finding reflects the importance of upfront BRAF testing of the genetically distinct population of Pakistan. Previously unreported mutations identified in the sample may be of clinical significance and warrant further investigation. The concomitant high expression and significant association between CD133 and BRAFV600E represent vital actionable genes that may be targeted together to improve CRC patient management.

Colorectal cancer remains a major cause of cancer-related morbidity and mortality worldwide, yet genomic profiling and personalized oncology are far from being a clinical reality in many underdeveloped countries. Our motivation stemmed from a deep concern over this disparity. Despite a growing burden of colorectal cancer in our region, there was a notable absence of local molecular data, particularly regarding actionable mutations such as KRAS and BRAF, which guide prognosis and therapy.

We aimed to generate baseline genomic data regarding BRAF mutations for our local population and identify associated molecular events. Genetic testing services in our country are accessible only to a privileged few, and targeted therapy options are virtually non-existent in public-sector hospitals. This reality adds urgency to our efforts, as the lack of infrastructure perpetuates a cycle of late diagnosis, suboptimal treatment, and poor outcomes.

 We hope our work not only contributes to colorectal cancer research but also highlights the need for greater investment in molecular oncology infrastructure in under-resourced settings.

 

Please sign in or register for FREE

If you are a registered user on Research Communities by Springer Nature, please sign in

Follow the Topic

Biomedical Research
Life Sciences > Health Sciences > Biomedical Research
Cancer Biology
Life Sciences > Biological Sciences > Cancer Biology
  • BMC Cancer BMC Cancer

    This is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers.

Related Collections

With Collections, you can get published faster and increase your visibility.

Genitourinary cancers: advances in research, diagnosis, and treatment

BMC Cancer is calling for submissions to our Collection on Genitourinary cancers: Advances in research, diagnosis, and treatment.

Genitourinary cancers, spanning a wide range of malignancies affecting both the urinary and reproductive systems, represent a significant global health challenge. These malignancies affect millions of individuals worldwide and are associated with substantial morbidity and mortality. Recent advancements in understanding the molecular and genetic underpinnings of these cancers have paved the way for innovative diagnostic and therapeutic approaches. As researchers continue to explore the complexities of genitourinary tumors, a clearer picture of their pathophysiology is emerging, which is crucial for developing targeted treatment strategies.

The ongoing research in genitourinary cancers is pivotal for improving patient outcomes. With the advent of precision medicine, immunotherapy, and novel biomarker identification, there have been significant strides in tailoring treatments to individual patients. For instance, the incorporation of genomic profiling in clinical practice has revolutionized our approach to managing prostate cancer, enabling more effective and personalized therapies. Furthermore, ongoing clinical trials are continually expanding our knowledge base, ultimately aiming to enhance survival rates and quality of life for patients diagnosed with these cancers.

Continued research in this field holds the promise of further breakthroughs in diagnostics and treatment modalities. As our understanding of the molecular drivers of genitourinary cancers deepens, we may witness the development of innovative therapeutic agents, enhanced screening methods, and more effective strategies for early detection. Future research could also lead to better integration of multidisciplinary approaches, offering hope for improved management and outcomes for patients facing these challenging diseases.

This Collection welcomes research articles on topics including, but not limited to:

- Genetic mutations and molecular pathways in genitourinary cancers

- Advances in biomarker discovery for early detection

- Imaging technology for early detection

- Liquid biopsy

-Genomic testing for personalized treatment plans

- Immuno-oncology combinations and novel drug classes

- Role of surgery and minimally invasive procedures

- Targeted therapies for specific genitourinary malignancies

- Overcoming resistance to chemotherapy and targeted therapies

- New clinical trials and cutting-edge research

- Translational research bridging laboratory findings to clinical applications

All manuscripts submitted to this journal, including those submitted to collections and special issues, are assessed in line with our editorial policies and the journal’s peer-review process. Reviewers and editors are required to declare competing interests and can be excluded from the peer review process if a competing interest exists.

Publishing Model: Open Access

Deadline: May 15, 2026

Cancer control in low- and middle-income countries – Part II

In recent years, non-communicable diseases, including cancer, have shown a disproportionate increase in incidence and related mortality in low- and middle-income countries (LMICs). By 2030, approximately three-quarters of all cancer deaths will occur in LMICs, with one in eight people experiencing a cancer diagnosis in their lifetime. Reasons for disparate trends include better risk factor control in high-income countries (lower infection-associated cancers, anti-smoking campaigns, and other preventive measures), educational resources, increased number of screening and surveillance programs with earlier detection of disease, and access to more effective cancer therapies. In contrast, many LMICs experience rising cancer incidence rates due to demographic transitions marked by aging population structures and a shift in prevalent risk factors (e.g., increasing tobacco use, alcohol consumption, unhealthy diets, physical inactivity). The underlying factors are complex and interrelated, contextualized to each country's setting, and merit further study.

In 2015, the United National General Assembly adopted the 2030 Agenda for Sustainable Development Goals (SDGs), built on the principle of “leaving no one behind.” The goals highlighted the importance of fighting inequalities across the world, and specifically, two goals, SDG 3: Good Health and Well-Being and SDG 10: Reduced Inequalities, have the ambitious aim of reducing disparities within and among countries and ensuring healthy lives for all at all ages. In addition, the 2020 WHO report on cancer clearly states that cancer control is an integral component of the path toward universal health coverage and achieving SDGs. By investing wisely and equitably, cancer cases and deaths can be avoided, and premature mortality can be reduced by 2030.

Hence, to combat the high mortality of preventable and treatable cancer in LMICs, urgent efforts are needed to improve cancer control programs and educate the public to bridge knowledge gaps, address misconceptions, and debunk myths. In addition, several gaps in the research enterprise of LMICs, such as the scarcity of reliable data, a lack of clinical trials, as well as the lack of infrastructure and trained human resources, must be addressed to solve local and regional problems with acceptable, feasible, effective, and implementable solutions.

In recognition of this relevant field, we encourage submissions including but not limited to those addressing:

• Patient navigation in cancer care and its role in cancer control in LMICs

• Training of the workforce caring for patients with cancer in LMICs

• Decentralization of cancer care in LMICs

• Technology, infrastructures, and the need for implementation in cancer care in LMICs

• The role of AI and digital health in cancer care in LMICs

• Financial burden of cancer care on patients and their families

• The role of cancer registries in strengthening cancer control in LMICs

• Defining optimal cancer treatment approaches in LMICs using local evidence

• Clinical trials and cancer in LMICs

• Anticipation medicine and cancer in LMICs

• Trends in cancer research in LMICs

• National cancer control plans and their utility in LMICs and barriers to implementation

• Twinning and partnership in cancer care in LMICs

All manuscripts submitted to this journal, including those submitted to collections and special issues, are assessed in line with our editorial policies and the journal’s peer-review process. Reviewers and editors are required to declare competing interests and can be excluded from the peer review process if a competing interest exists.

This Collection supports and amplifies research related to SDG 3: Good Health and Well-Being and SDG 10: Reduced Inequalities.

Publishing Model: Open Access

Deadline: Aug 14, 2026