Fig. 1: CONSORT diagram of this study.

Tissue samples from 647 RAS MT mCRC patients are initially included. Among these, samples from 169 patients are excluded; finally, samples from 478 patients are included in the analysis. Somatic mutations in KRAS and NRAS are detected in 387 patients with mCRC in their plasma. Thus, the incidence of NeoRAS WT mCRC in Group A is 19%. Overall, 30 patients have no detectable genetic alteration, and 2 patients have germline mutations. The possibility of CH cannot be ruled out in 17 patients. Therefore, the incidence of NeoRAS WT mCRC in Group B is 9.8%. ctDNA: circulating tumor DNA, RAS: rat sarcoma viral oncogene homolog, WT wild-type, MT mutant, CH clonal hematopoiesis, mCRC metastatic colorectal cancer.