The role of KRAS mutation testing in the management of patients with metastatic colorectal cancer.

Abstract:

CONTEXT:KRAS mutations can be detected in approximately 30% to 40% of all patients with colorectal cancer. Several recent studies have shown that patients with KRAS mutations in codons 12 or 13 in metastatic tumors do not benefit from anti-epidermal growth factor receptor therapy with cetuximab or panitumumab. OBJECTIVE:To review the literature on the role of KRAS mutation testing for management of patients with metastatic colorectal cancer and to discuss testing strategies. DATA SOURCES:This review is based on published, peer-reviewed literature; available information from medical organizations (eg, National Comprehensive Cancer Network, American Society of Clinical Oncology, College of American Pathologists); and information from clinical laboratories conducting KRAS mutation analysis. CONCLUSIONS:Multiple methods for detecting KRAS mutations in colorectal tumors are available, and all methods in current clinical use appear to have adequate clinical sensitivity for predicting a lack of response to cetuximab and panitumumab. Pathologist expertise is essential to quality KRAS testing and to determining effective treatment for patients with metastatic colorectal cancer.

journal_name

Arch Pathol Lab Med

authors

Monzon FA,Ogino S,Hammond ME,Halling KC,Bloom KJ,Nikiforova MN

doi

10.1043/1543-2165-133.10.1600

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

1600-6

issue

10

eissn

0003-9985

issn

1543-2165

pii

2009-0111-RAR

journal_volume

133

pub_type

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