Molecular spectrum of KRAS, NRAS, BRAF, PIK3CA, TP53, and APC somatic gene mutations in Arab patients with colorectal cancer: determination of frequency and distribution pattern

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second most common in females, worldwide (1). CRC incidence has been increasing in Arab countries such as Kuwait and Saudi Arabia (2,3). In Saudi Arabia, the incidence of CRC accounted for 10.4% of all cancers in 2010; it was the most common cancer in males and the third most common in females, after breast and thyroid cancers (4). In the Kuwaiti population, CRC was the most common cancer in males (11.3%) and the second most common in females (9.1%) in 2000–2009 (5). Gene mutation and defective cell regulation are important processes in the development of CRC (6). Accumulation of these mutations, including mutations in KRAS, NRAS, BRAF and PIK3CA, activate multiple signaling pathways, such as RAS-RAF-MAPK and PI3K-PTEN-AKT, that play a major role in regulating cell proliferation, angiogenesis, cell motility and apoptosis (7-9)