Department of Public Health, University of Naples Federico II, Naples, Italy.
Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
Eur J Cancer. 2021 Mar;146:74-83. doi: 10.1016/j.ejca.2021.01.015. Epub 2021 Feb 12.
Rat sarcoma (RAS) oncogenes have intensively been investigated during the last decades. Taking into account all human tumours, Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) gene is the most frequently mutated (about 22%) among the three isoforms, followed by Neuroblastoma RAS Viral Oncogene Homolog (NRAS) (8%) and Harvey Rat Sarcoma Viral Oncogene Homolog (HRAS) (3%). In the last years, careful attention has been paid on KRAS and NRAS gene mutations in non-small-cell lung cancer (NSCLC) and colorectal cancer (CRC) patients because of their prognostic and predictive roles. In particular, a large body of literature data has been generated investigating clinical outcomes of targeted treatments in NSCLC and CRC KRAS- and NRAS-mutated patients. The latest evidences are here reviewed, providing also an overview of the real-world RAS mutation testing practice across different Italian laboratories. On this basis, we propose a knowledge-based system, www.rasatlas.com, to support the healthcare personnel in the management of patients featuring RAS gene mutations in the landscape of precision oncology.
在过去的几十年里，人们对大鼠肉瘤（RAS）癌基因进行了深入研究。考虑到所有人类肿瘤，Kirsten 大鼠肉瘤病毒癌基因同源物（KRAS）基因是三种亚型中突变最频繁的（约 22%），其次是神经母细胞瘤 RAS 病毒癌基因同源物（NRAS）（8%）和 Harvey 大鼠肉瘤病毒癌基因同源物（HRAS）（3%）。在过去的几年中，由于 KRAS 和 NRAS 基因突变在非小细胞肺癌（NSCLC）和结直肠癌（CRC）患者中的预后和预测作用，人们对其给予了特别关注。特别是，大量的文献数据已经产生，研究了 NSCLC 和 CRC KRAS 和 NRAS 突变患者的靶向治疗的临床结果。本文回顾了最新的证据，并概述了意大利不同实验室的真实世界 RAS 突变检测实践。在此基础上，我们提出了一个基于知识的系统 www.rasatlas.com，以支持医疗保健人员在精准肿瘤学领域管理具有 RAS 基因突变的患者。
