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Published on: September 30, 2016
[KRAS mutation testing in therapeutic algorithm for treatment of metastatic colorectal carcinoma]
Lenka Dubská1, Martina Vyskocilová, Rudolf Nenutil
1Oddeleni laboratorní medicíny, Masarykův onkologický ustav, Brno dubska@mou.cz
Abstract:
Targeted therapy has become an integral part of treatment procedures of malignant tumors. Colorectal carcinomas are frequently targeted with monoclonal anti-EGFR antibodies (cetuximab and panitumumab). Activating somatic mutations in codons 12 and 13 of the exon 2 of KRAS gene are considered negative predictive factors of response to anti-EGFR therapy in patients with metastatic colorectal cancer. In the Czech Republic, evaluation of mutational status of KRAS gene is performed in several referral laboratories. In 2009, these laboratories performed 2580 tests of the KRAS mutational status--out of these, 60.2% cases reported non-mutated, wild-type KRAS. In one of the referral laboratories, we demonstrate the logistics of KRAS testing procedure. Stratification of patients with metastatic colorectal tumors based on their KRAS mutational status has evolved to a standard procedure. Laboratories performing these methods shall therefore adhere to the recommendations of the professional and accredited societies.
Insights
KRAS gene mutation testing is crucial for predicting colorectal cancer patient response to targeted anti-EGFR therapies. Wild-type KRAS results were common in a Czech Republic study, highlighting the need for standardized testing procedures.
Area of Science:
- Oncology
- Molecular Diagnostics
- Genetics
Background:
- Targeted therapy, particularly monoclonal anti-EGFR antibodies like cetuximab and panitumumab, is a cornerstone in treating malignant tumors.
- Activating somatic mutations in codons 12 and 13 of the KRAS gene's exon 2 are established negative predictive factors for anti-EGFR therapy response in metastatic colorectal cancer (mCRC).
Purpose of the Study:
- To detail the logistics and significance of KRAS mutational status testing in a Czech Republic referral laboratory.
- To emphasize the importance of KRAS testing for patient stratification in metastatic colorectal cancer treatment.
Main Methods:
- Analysis of KRAS gene mutational status using molecular diagnostic techniques.
- Review of testing procedures and data from referral laboratories in the Czech Republic.
Main Results:
- In 2009, 2580 KRAS mutational status tests were conducted in the Czech Republic, with 60.2% reporting wild-type KRAS.
- Demonstration of the practical workflow for KRAS testing in a specific referral laboratory.
Conclusions:
- Stratification of metastatic colorectal cancer patients based on KRAS mutational status is a standard clinical procedure.
- Laboratories performing KRAS testing must adhere to professional and accredited society recommendations for consistent and reliable results.
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