Molecular Pathology Laboratory Network

KRAS Mutation, EGFR Inhibitor Response Featured

Test Code
KRAS
Associations
EGFR inhibitor, tyrosine kinase inhibitors (TKI), Colorectal cancer, NSCLC
Methodology
Primer-extension PCR utilizing shifted termination assay (STA) technology followed by capillary electrophoresis (CE)
CPT Codes
Please contact a client service specialist at 800.932.2943
Turnaround Time
8-10 business days
Specimen Requirements
10% neutral buffered formalin fixed paraffin embedded tissue (Notify MPLN when other fixatives are used.)
NOTE: Include a surgical pathology report with the sample.
Specimen Stability
Stable at 18-25°C indefinitely
Storage & Handling
Ship ambient
Causes for Rejection
Improper specimen labeling; Insufficient sample; Inadequate fixation and/or processing
Reference Range
The assay detects 12 mutations found in codon 12 and 13 of the KRAS oncogene
Codon 12
  • Gly12Ser (GGT>AGT)
  • Gly12Arg (GGT>CGT)
  • Gly12Cys (GGT>TGT)
  • Gly12Asp (GGT>GAT)
  • Gly12Ala (GGT>GCT)
  • Gly12Val (GGT>GTT)

Codon 13
  • Gly13Ser (GGC>AGC)
  • Gly13Arg (GGC>CGC)
  • Gly13Cys (GGC>TGC)
  • Gly13Asp (GGC>GAC)
  • Gly13Ala (GGC>GCC)
  • Gly13Val (GGC>GTC)
Related Content
BRAF; CellSearch; I MSI
Description
Utilized as an independent predictor of colorectal cancer (CRC) and patient responsiveness to EGFR (TKI) inhibitor therapy.
References
  1. Siena S et al (2009). Biomarkers Predicting Clinical Outcome of Epidermal Growth Factor Receptor - Targeted Therapy in Metastatic Colorectal Cancer. JNCI. 101: 1308-1324
  2. Allegra C J et al. (2009). ASCO Provisional Clinical Opinion: Testing for KRAS Gene Mutations in Patients with Metastatic Colorectal Carcinoma to Predict Response to Anti-Epidermal Growth Factor Receptor Monoclonal Antibody Therapy. JCO. 27: 2091-2096
  3. V. Shankaran et al. (2009). Economic implications of Kras testing in metastatic colorectal cancer (mCRC). Gastrointestinal Cancers Symposium. Abstratct No. 298.
  4. Tol J. (2009). Chemotherapy, bevacizumab and cetuximab in metastatic colorectal cancer. N Engl J Med. 360:563-72.
  5. De Roock W et al. (2008). KRAS wild-type state predicts survival and is associated to early radiological response in metastatic colorectal cancer treated with cetuximab. Ann Oncol. 19:508-515.
  6. Karapetis CS et al. (2008). K-ras Mutations and benefit from cetuximab in advanced colorectal cancer. NEJM. 359:1757-1765.
  7. Lievre A et al (2008). KRAS mutations as an independent prognostic factor in patients with advanced colorectal cancer treated with cetuximab. J Clin Oncol. 26:374-379.
  8. NCCN Practice Guidelines v.3.2008. www.nccn.org.
  9. Di Fiore F et al. (2007). Clinical relevance of KRAS mutation detection in metastatic colorectal cancer treated by Cetuximab plus chemotherapy. Br J Cancer. 96:1166-1169.
  10. Lievre A et al. (2007). KRAS mutation status is predictive of response to cetuximab therapy in colorectal cancer. Cancer Res. 66:3992-3995.

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