Department of Gastroenterology, CHU Pontchaillou, 2 Rue Henri le Guilloux, 35000 Rennes, France; University of Rennes 1, 2 Avenue du Professeur Léon Bernard, 35000 Rennes, France; INSERM U1242, Oncogenesis, Stress & Signaling, rue de la Bataille Flandres Dunkerque, 35000 Rennes, France.
University of Lorraine, 34 Cours Léopold, 54000 Nancy, France; CNRS UMR7039 CRAN, Boulevard des Aiguillettes, 54506 Vandoeuvre-lès-Nancy, France; Biopathology Department, Cancer Institute of Lorraine, 6 Avenue de Bourgogne, 54519 Vandoeuvre-lès-Nancy, France.
Dig Liver Dis. 2018 May;50(5):507-512. doi: 10.1016/j.dld.2017.12.029. Epub 2018 Jan 8.
RAS (NRAS + KRAS) mutation testing is required in addition to simple KRAS testing prior to initiating anti-epidermal-growth-factor-receptor (EGFR) antibodies (MAb) as in metastatic colorectal cancer (mCRC).
To assess prescription and implementation rates of RAS/KRAS mutation testing. To describe the RAS/KRAS mutation test procedure and its impact on therapeutic strategy.
Observational retrospective study conducted from June to September 2014 in all consecutive patients with newly diagnosed mCRC.
Data from 375 patients (male: 57.8%; mean age, 65.7 ± 11.7 years) were analysed. RAS/KRAS mutation testing was prescribed in 90.1% of patients (338/375). The test was prescribed within 1 month around mCRC diagnosis and prior to first-line therapy in 73.1% (242/331) and 85.4% (280/328) of patients, respectively. Time from test request to receipt of results was 24.6 ± 17.2 days. 59.7% of patients (190/318) had a mutation, mainly KRAS (47.9%; 152/317). Anti-EGFR MAb was prescribed in 90.9% of RAS-wild-type cases (60/66), consistent with the goal of genotyping-testing in this population.
In 2014, RAS genotyping-testing in addition to KRAS testing was routinely prescribed and performed in mCRC patients in France. Time to receive results remains long and must be reduced so as to match clinical practice.
在转移性结直肠癌（mCRC）中，在开始使用抗表皮生长因子受体（EGFR）抗体（单抗）之前，除了简单的 KRAS 检测外，还需要进行 RAS（NRAS+KRAS）突变检测。
评估 RAS/KRAS 突变检测的开方和实施率。描述 RAS/KRAS 突变检测程序及其对治疗策略的影响。
这是一项于 2014 年 6 月至 9 月在所有新诊断的 mCRC 连续患者中进行的观察性回顾性研究。
共分析了 375 例患者（男性：57.8%；平均年龄 65.7±11.7 岁）的数据。90.1%（338/375）的患者进行了 RAS/KRAS 突变检测。73.1%（242/331）和 85.4%（280/328）的患者在 mCRC 诊断后 1 个月内及一线治疗前开方进行了该检测。从检测申请到获得结果的时间为 24.6±17.2 天。59.7%（190/318）的患者发生了突变，主要是 KRAS（47.9%；152/317）。在 RAS 野生型病例中，90.9%（60/66）的患者开了抗 EGFR 单抗，这与该人群基因分型检测的目标一致。
2014 年，法国的 mCRC 患者常规开方并进行了除 KRAS 检测外的 RAS 基因分型检测。获得结果的时间仍然很长，必须缩短，以符合临床实践。
