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Meta-Analysis Supports Consideration of MSI Status in BRAF V600E-Positive CRC
Meta-analysis findings suggest that microsatellite instability (MSI) status should be considered as a stratification factor for better management of patients with BRAF V600E-positive colorectal cancer (CRC; Pathol Res Pract. 2020 ;216[1]:152791).
According to Moxin Wu, MD, Department of Medical Laboratory, Affiliated Hospital of Jiujiang University, China, and colleagues, patients with microsatellite stable (MSS) BRAF V600E-positive CRC have a poor prognosis compared with patients who have MSI in BRAF V600E-positive CRC.
“Although usually considered a single clinical entity, the MSI BRAF-CRC subtype shows some distinct characteristics in comparison with the MSS BRAF-CRC subtype,” they continued.
To this end, Dr Wu et al carried out a meta-analysis evaluating the effect clinicopathologic features have on MSI status in patients with BRAF V600E-positive CRC using PubMed, Embase, and the Cochrane Library databases.
Odds ratios (ORs) with 95% CIs and fixed- or random-effects models based on heterogeneity were used to evaluate the effect of MSI status on outcome parameters.
Of 2839 reports reviewed, 16 studies comprising 1381 patients with BRAF V600E-positive CRC were deemed eligible for inclusion in the analysis.
Overall, the MSI BRAF V600E-positive CRC subtype was found to be tied to older age, female sex (OR, 1.70; 95% CI, 1.35-2.14; P <.00001), proximal tumor location (OR, 5.10; 95% CI, 3.70-7.03; P <.00001), early TNM stage (OR, 5.28; 95% CI, 3.93-7.09; P <.00001), and poor differentiation (OR, 2.29; 95% CI, 1.60-3.28; P <.00001).
“MSI was significantly correlated with distinct favorable clinicopathological characteristics in [BRAF V600E-positive CRC]," Dr Wu and colleagus said.
"These results suggest that MSI status should be considered as a stratification factor for better management of [BRAF V600E-positive CRC]," they concluded.—Hina Porcelli
