Test Name
KRAS Mutation Analysis
Test Code
M KRAS
Associations
EGFR inhibitor, Colorectal cancer, NSCLC;
Tyrosine kinase inhibitors (TKI): Erbitux® (cetuximab), Vectibix™ (panitumumab)
CPT Codes
81275
Turnaround Time
10 days
Specimen Requirements
Formalin Fixed Paraffin Embedded tissue block 3 slides (3-5 uM) per marker on adhesion glass NOTE: Include a surgical pathology report with the sample if sending a block and/or slides 5.0 mL (min. 3.0 mL) whole blood EDTA, Sodium Heparin or ACD 3.0 mL (min. 1.0 mL) bone marrow EDTA, Sodium Heparin or ACD
Specimen Stability
Indefinite at ambient temperature (18-25°C) Whole blood and Bone Marrow stable at 18-25°C for 72 hours or 4°C for up to 7 days
Storage & Handling
Ship ambient. Protect from extreme temperature with an ice pack. Separate ice pack from specimen
Causes for Rejections
Improper specimen labeling; Insufficient sample volume; Clotted specimen; Specimen older than 7 days
Description
Utilized as an independent predictor of colorectal cancer (CRC) and patient responsiveness to EGFR (TKI) inhibitor therapy.
References
- Sepulveda et al. (2017) Molecular Biomarkers for the Evaluation of Colorectal Cancer: Guideline From the American Society for Clinical Pathology, College of American Pathologists, Association for Molecular Pathology, and the American Society of Clinical Oncology. J Clin Oncol. 2017 Feb 6:JCO2016719807
- Neumann J et al. Epub 2009 Frequency and type of KRAS mutations in routine diagnostic analysis of metastatic colorectal cancer. Pathol. Res.Pract. 205(12), 858.
- Siena S et al (2009). Biomarkers Predicting Clinical Outcome of Epidermal Growth Factor Receptor - Targeted Therapy in Metastatic Colorectal Cancer. JNCI. 101: 1308-1324
- 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
- V. Shankaran et al. (2009). Economic implications of Kras testing in metastatic colorectal cancer (mCRC). Gastrointestinal Cancers Symposium. Abstratct No. 298.
- Tol J. (2009). Chemotherapy, bevacizumab and cetuximab in metastatic colorectal cancer. N Engl J Med. 360:563-72.
- 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.
- Karapetis CS et al. (2008). K-ras Mutations and benefit from cetuximab in advanced colorectal cancer. NEJM. 359:1757-1765.
- 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.
- NCCN Practice Guidelines v.3.2008. www.nccn.org.
- 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.
- Lievre A et al. (2007). KRAS mutation status is predictive of response to cetuximab therapy in colorectal cancer. Cancer Res. 66:3992-3995.
