Association of Immune Score, KRAS, NRAS, and BRAF Mutation with Clinicopathological Aspects Among Indonesian Colorectal Cancer Cases

Introduction: Colorectal cancer ranked as the leading three cancers in Indonesia presented with various clinical characteristics that remain a pressing challenge. KRAS, NRAS, and BRAF are mostly found mutations that become an essential part in the assessment of CRC patients. Immune score (IS) is a widely applicable prognostic factor sensitive in deciding the degree of immunity which is useful in selecting tailored treatment options. This research focused to define the characteristics of immune scores in various mutational states of KRAS, NRAS, and BRAF and explore its association with relevant clinicopathological aspects. Methods: This is a retrospective cohort study analyzing genomic and immune score profiles of 237 CRC patients treated at three cancer-center hospitals in Jakarta. The biomarkers studied were collected from Kalgen Laboratory between February 2011 and December 2023 and were analyzed using univariate analyses. Result: The majority (70%) of patients had high immunity with KRAS mutation observed in 83 (86.5%) patients, NRAS in 9 (9.4%) patients, and BRAF in 4 (4.2%) patients. Several significant associations were identified between immune score, mutational status, and clinicopathological features (p<0.05). Conclusion: Our findings indicated that immune score acts as a beneficial indicator primarily for stage II CRC. Mutational status remains an essential assessment as they were significantly associated with related clinicopathological features. These highlight the relevance of comprehensive genomic evaluation along with host immune scoring.