Tumors often have KRAS mutations. It occurs in around 30% of all cancer cases and almost 50% of metastatic colorectal cancer cases, a leading cause of cancer-related deaths globally. KRAS mutations plays a significant role in CRC progression, as recent advancements in CRC biology and genetics have revealed. KRAS gene encodes a GTPase that regulates growth factor and receptor signal pathways. KRAS mutations commonly occur in codons 12 and 13, possessing oncogenic characteristics. Abnormal KRAS activation boosts cancer-associated signals in CRC, including cell growth, movement, and new blood vessel formation. We examine the prognostic implications of KRAS mutations in this review. The KRAS p.G12C mutation is linked to a poorer prognosis in metastatic CRC. Mutations in amino acids at the same position in a protein can unexpectedly contribute to cancer due to the interplay of structure and conformation. Additionally, we provide a summary of the clinical evidence for the efficacy of novel inhibitors in targeting KRAS p.G12C as a potential treatment for metastatic CRC.
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