NRAS, KRAS, and BRAF mutations in gastric cancer: a comprehensive analysis of Russian and international data

Mutations in the RAS/RAF gene family, including KRAS, NRAS, and BRAF, play an important role in the development of malignant neoplasms of various etiologies. In gastric cancer, these mutations are much less common, but still have important clinical significance. KRAS mutations lead to a worse prognosis, reduced effectiveness of anti-EGFR therapy, and require the use of immunotherapy in MSI-positive (MSI+) cases. BRAF mutations are characterized by an aggressive course of the disease, but are vulnerable to targeted therapy. An analysis of Russian studies has shown that the frequency of KRAS mutations among citizens of the Russian Federation does not differ significantly from the international level, reaching 7.5–9%. At the same time, NRAS and BRAF mutations are extremely rare. Particular attention is paid to the MSI+ subtype. Among Russian patients, only 19% are found to have KRAS mutations, which is significantly less than global statistics. To date, there is a serious lack of statistical data on the characteristics of the mutation profile of gastric cancer among residents of the Russian Federation. A large-scale and in-depth study of this topic will significantly increase the effectiveness of therapy and make a major contribution to the development of clinical oncology. Standardization of molecular diagnostic methods and the introduction of comprehensive molecular testing are necessary to increase the effectiveness of personalized therapy and improve disease outcomes.