KRAS mutation testing in therapeutic algorithm for treatment of metastatic colorectal carcinoma
Authors:
Lenka Dubská 1; Martina Vyskočilová 1; Rudolf Nenutil 1; Dalibor Valík 1; Dana Knoflíčková 1; Pavel Fabian 1; Ilona Kocáková 1; Regina Demlová 1; Martin Beránek 2; Monika Drastíková 2; Hana Vošmiková 2; Arpád Bóday 3; Kateřina Horká 3; Jarmila Šímová 4; Jiří Drábek 5; Jiří Ehrmann ml. 5; Marián Hajdúch 5; Milada Matějčková 6; Radek Šíma 7; Daniel Tvrdík 8; Ctibor Povýšil 8; Aleš Ryška 9
Authors‘ workplace:
Masarykův onkologický ústav, Brno
1; Univerzita Karlova v Praze, Lékařská fakulta Hradec Králové, Ústav klinické biochemie a diagnostiky FN
2; P & R LAB a. s., Nový Jičín
3; CGB laboratoř a. s., Ostrava
4; Univerzila Palackého v Olomouci, Ústav molekulární a translační medicíny LF
5; Fakultní Thomayerova nemocnice s poliklinikou v Praze, Oddělení patologie a molekulární medicíny
6; Bioptická laboratoř s. r. o., Plzeň
7; Univerzita Karlova v Praze, 1. lékařská fakulta, Ústav patologie VFN
8; Univerzita Karlova v Praze, Lékařská fakulta Hradec Králové, Fingerlandův ústav patologie FN
9
Published in:
Čas. Lék. čes. 2011; 150: 321-326
Category:
Review Article
Overview
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.
Key words:
k-ras, colorectal carcinoma, targeted therapy, anti-EGFR therapy, predictive molecular oncology, standardization of diagnostic procedure.
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Journal of Czech Physicians
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