RAS testing of colorectal carcinoma—a guidance document from the Association of Clinical Pathologists Molecular Pathology and Diagnostics Group

J Clin Pathol. 2014 Sep;67(9):751-7. doi: 10.1136/jclinpath-2014-202467.

Abstract

Analysis of colorectal carcinoma (CRC) tissue for KRAS codon 12 or 13 mutations to guide use of anti-epidermal growth factor receptor (EGFR) therapy is now considered mandatory in the UK. The scope of this practice has been recently extended because of data indicating that NRAS mutations and additional KRAS mutations also predict for poor response to anti-EGFR therapy. The following document provides guidance on RAS (i.e., KRAS and NRAS) testing of CRC tissue in the setting of personalised medicine within the UK and particularly within the NHS. This guidance covers issues related to case selection, preanalytical aspects, analysis and interpretation of such RAS testing.

Publication types

  • Practice Guideline

MeSH terms

  • Biomarkers, Tumor / genetics*
  • Carcinoma / drug therapy
  • Carcinoma / genetics*
  • Carcinoma / pathology
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / pathology
  • DNA Mutational Analysis / standards*
  • Drug Resistance, Neoplasm / genetics
  • GTP Phosphohydrolases / genetics*
  • Genetic Predisposition to Disease
  • Genetic Testing / standards*
  • Humans
  • Membrane Proteins / genetics*
  • Mutation*
  • Phenotype
  • Precision Medicine / standards
  • Predictive Value of Tests
  • Prognosis
  • Proto-Oncogene Proteins / genetics*
  • Proto-Oncogene Proteins p21(ras)
  • Quality Control
  • Quality of Health Care / standards
  • ras Proteins / genetics*

Substances

  • Biomarkers, Tumor
  • KRAS protein, human
  • Membrane Proteins
  • Proto-Oncogene Proteins
  • GTP Phosphohydrolases
  • NRAS protein, human
  • Proto-Oncogene Proteins p21(ras)
  • ras Proteins