NGS technologies and metastatic colorectal cancer: Experience and future in Uzbekistan.

e15638 Background: Colorectal cancer (CRC) is a growing concern in Uzbekistan, with an incidence of 5.5 per 100,000 people in 2024. It accounts for 10% of cancers in men and 5.1% in women. Metastatic CRC presents challenges due to high recurrence rates and limited resectability. While molecular diagnostics like KRAS/NRAS mutation and microsatellite instability (MSI) testing have improved global CRC outcomes through targeted therapies, these methods remain underutilized in Uzbekistan, where standard chemotherapy is still the primary treatment. Methods: This study included data from 75 metastatic CRC patients treated at the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology in Uzbekistan (2018–2024). Group 1 (38 patients) received standard chemotherapy without genetic testing, while Group 2 (39 patients) underwent molecular testing for personalized treatment. Results: In Group 1, only 12.1% of patients were eligible for surgery, with a 3-year recurrence rate of 55.4%. In Group 2, molecular testing identified actionable mutations, allowing for targeted therapies. Surgical resection was achieved in 25.7% of patients, and the 3-year recurrence rate dropped to 35.9%. Conclusions: Molecular testing improves treatment outcomes and highlights the need for its integration into clinical practice in Uzbekistan to enhance resectability, reduce recurrence, and optimize patient outcomes.