Mutation Combinations Database

Comprehensive guide to genetic mutation combinations in colorectal cancer, their clinical implications, and treatment recommendations.

64
Total Combinations
39
Actionable Targets
14
Categories
Showing 64 combinations
RET Fusion
Intermediate
RET
0.20% prevalence Actionable

Very rare but highly actionable.

Recommended
Selpercatinib Pralsetinib
Rare Fusions
Level 2A
ALK Fusion
Intermediate
ALK
0.10% prevalence Actionable

Extremely rare. Case reports of responses.

Recommended
Alectinib Lorlatinib Crizotinib
Rare Fusions
Level 3
ROS1 Fusion
Intermediate
ROS1
0.10% prevalence Actionable

Ultra-rare. ROS1 inhibitors may help.

Recommended
Entrectinib Crizotinib
Rare Fusions
Level 3
KRAS + APC
Intermediate
KRAS APC
30.00% prevalence

Recommended
Standard chemotherapy Bevacizumab-based
Avoid
Anti-EGFR monotherapy
General
B
KRAS + TP53
Intermediate
KRAS TP53
25.00% prevalence

Most common combination. Standard RAS-mutant treatment.

Recommended
FOLFOX + Bevacizumab FOLFIRI + Bevacizumab FOLFOXIRI + Bevacizumab
Avoid
Anti-EGFR
TP53 Combinations
Level 2B
APC + KRAS + TP53
Intermediate
APC KRAS TP53
20.00% prevalence

Classic Vogelstein adenoma-carcinoma sequence.

Recommended
FOLFOX + Bevacizumab FOLFIRI + Bevacizumab
Avoid
Anti-EGFR
TP53 Combinations
Level 2B
RAS Mutant + Right-Sided
Poor
KRAS NRAS
20.00% prevalence

Double negative prognostic factors. Aggressive biology.

Recommended
FOLFOXIRI + Bevacizumab Clinical trials
Avoid
Anti-EGFR
Tumor Location
Level 2A
HER2-Low
Intermediate
HER2
15.00% prevalence

Emerging category. T-DXd trials ongoing in CRC.

Recommended
Standard therapy Clinical trials
HER2 Pathway
Level 3
TP53 Mutated (RAS WT)
Intermediate
TP53
15.00% prevalence

Does not preclude anti-EGFR if RAS/BRAF wild-type.

Recommended
Anti-EGFR therapy Standard chemotherapy
TP53 Combinations
Level 3
KRAS G12D
Intermediate
KRAS
12.00% prevalence

Most common KRAS. MRTX1133 and other G12D inhibitors in development.

Recommended
FOLFOX + Bevacizumab FOLFIRI + Bevacizumab Clinical trials
Avoid
Cetuximab Panitumumab
RAS Pathway
Level 2A
APC + KRAS + TP53 + SMAD4
Poor
APC KRAS TP53 SMAD4
12.00% prevalence

SMAD4 loss = poor prognosis, liver mets.

Recommended
FOLFOXIRI + Bevacizumab Clinical trials
TP53 Combinations
Level 2B
KRAS G12D (Emerging)
Intermediate
KRAS
12.00% prevalence

MRTX1133 and others showing promise. Could transform treatment.

Recommended
Standard therapy Clinical trials
Emerging Targets
Level 3
About This Database

This database contains clinically relevant mutation combinations in colorectal cancer. Each combination includes:

  • Genes involved - The genetic alterations present
  • Prognosis - Expected outcome classification
  • Prevalence - How common in CRC patients
  • Recommended treatments - Evidence-based options
  • Treatments to avoid - Known ineffective therapies
  • Evidence level - Strength of supporting data

Actionable combinations have FDA-approved targeted therapies or strong clinical trial evidence. Always consult with your oncologist for personalized treatment decisions.