Determination of a mutational status of the BRAF gene in patients with metastatic colorectal cancer in routine clinical practice: results of a survey of doctors in the Russian entities

Abstract

Background: colorectal cancer (CRC) is one of the most common cancers in developed countries. The BRAF V600E mutation found in 8-10% of cases of metastatic CRC (mCRC) is a diagnostic, predictive and prognostic marker of the disease course. V600E (i. e., valine replacement with glutamic acid) is the most common CRC-associated subtype of BRAF mutation. Availability, scope, and time limits of a molecular genetic testing may be entity-specific. Aim: to evaluate availability, scope and time limits of a molecular genetic testing in mCRC patients in routine clinical practice in Russia. Materials and Methods: from January to April 2025, an anonymous online survey was conducted in oncologists, chemotherapists, and department heads who refer patients with mCRC for a molecular genetic testing. The survey including 12 questions was conducted on the website of the Moscow Cancer Society. Results: 124 doctors from different Russian entities participated in the survey. On average, about 80% of mCRC patients are referred to a molecular genetic testing for the BRAF gene mutation. Approximately 20% of the responders are unaware of three classes of BRAF mutation. PCR is the main method of a molecular genetic testing for BRAF mutation. 31.5% of the doctors prefer avoiding a high throughput sequencing (NTS) to detect mCRC-associated mutations, 25.8% of practitioners prescribe an NTS test only if a hereditary abnormality is suspected. 43.5% of doctors wait for the test results for more than 15 days. Conclusion: in our country, a BRAF mutation test is readily available due to various funding channels, while a lack of funding under the compulsory medical insurance program is one of the reasons to refuse from a BRAF mutation test. This indicates a need for measures to improve arrangement of the molecular genetic testing. Educational activities should also be carried out to increase oncologists' awareness of prognostic and predictive significance of the BRAF mutation associated with mCRC, as well as significance of the three classes and different subtypes of the BRAF mutation. Whenever possible, an effort should be made to refer mCRC patients for the molecular genetic testing before a start of a first-line therapy. KEYWORDS: colorectal cancer, BRAF mutation, molecular genetic testing, online survey. FOR CITATION: Trotsenko I.D., Andreyashkina I.I., Khatkov I.E. Determination of a mutational status of the BRAF gene in patients with metastatic colorectal cancer in routine clinical practice: results of a survey of doctors in the Russian entities. Russian Medical Inquiry. 2025;10(7):480–488 (in Russ.). DOI: 10.32364/2587-6821-2026-10-7-3