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Sangaré L, Delli-Zotti K, Florea A, Rehn M, Benson AB, Lowe KA. An evaluation of RAS testing among metastatic colorectal cancer patients in the USA. Future Oncol 2021; 17:1653-1663. [PMID: 33629919 DOI: 10.2217/fon-2020-1075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Data on RAS testing practices prior to metastatic colorectal cancer (mCRC) treatment initiation are lacking in the USA. Materials & methods: Flatiron data were utilized for patients diagnosed with mCRC between 2011 and 2017. Flatiron is a longitudinal, demographically and geographically diverse database representing data from over 1.5 million active US patients treated at 255 community and hospital-affiliated oncology clinics. Results: Among 17,387 mCRC patients 69% were RAS tested and 31% were never tested. Timing of RAS testing was as follows: 23% were tested at the time of their initial CRC diagnosis, 60% following mCRC diagnosis but prior to first line of treatment, 3% prior to third line, the remaining 14% were tested following third line. Conclusion: A third (31%) of patients failed to receive RAS testing, therefore all treatment options were unavailable to them. These data highlight how universal testing has not been achieved.
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Affiliation(s)
| | | | - Ana Florea
- Department of Medicine, University of Arizona, Tucson, AZ 85724, USA
| | | | - Al B Benson
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA
| | - Kimberly A Lowe
- Center for Observational Research, One Amgen Center Drive, Thousand Oaks, CA 91320, USA
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2
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Kafatos G, Banks V, Burdon P, Neasham D, Anger C, Manuguid F, Lowe KA, Cheung P, Taieb J, van Krieken JH. Biomarker testing and mutation prevalence in metastatic colorectal cancer patients in five European countries using a large oncology database. Future Oncol 2021; 17:1483-1494. [PMID: 33464119 DOI: 10.2217/fon-2020-0975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: The literature on biomarker testing for metastatic colorectal cancer (mCRC) in Europe is scarce. This study aimed to estimate the percentage of mCRC patients from five European countries tested for biomarkers over time. Materials & methods: An oncology database was retrospectively analyzed; evaluated biomarkers were RAS, BRAF and microsatellite instability (MSI). The patients were drug treated during 2018 and tested for relevant biomarkers in 2013-2018. Results: RAS testing was conducted in >90% of mCRC patients from 2014 onwards. BRAF testing increased from 31% of mCRC patients in 2013 to 67% in 2018. MSI testing increased from 10 to 41%. There was no notable trend over time for RAS and BRAF mutation or MSI-high prevalence. Conclusion: Biomarker testing among patients diagnosed with mCRC was increased over time. This study demonstrates the quick uptake of biomarker testing in clinical practice. These findings are significant as biomarker-based drugs are becoming more common.
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Affiliation(s)
- George Kafatos
- Amgen Ltd, Center for Observational Research, 1 Uxbridge Business Park, Sanderson Road, Uxbridge, UB8 1DK, UK
| | - Victoria Banks
- Amgen Ltd, Center for Observational Research, 1 Uxbridge Business Park, Sanderson Road, Uxbridge, UB8 1DK, UK
| | - Peter Burdon
- Amgen (Europe) GmbH, Suurstoffi 22, Postfach 94, 6343, Rotkreuz, Switzerland
| | - David Neasham
- Amgen Ltd, Center for Observational Research, 1 Uxbridge Business Park, Sanderson Road, Uxbridge, UB8 1DK, UK
| | - Caroline Anger
- IQVIA Ltd, Real-World & Analytics solutions, 210 Pentonville Road, London, N1 9JY, UK
| | - Fil Manuguid
- IQVIA Ltd, Real-World & Analytics solutions, 210 Pentonville Road, London, N1 9JY, UK
| | - Kimberly A Lowe
- Amgen, Inc., Center for Observational Research, One Amgen Center Drive, MS D2262, Thousand Oaks, CA 91320, USA
| | - Patrick Cheung
- Amgen Ltd, Center for Observational Research, 240 Milton Road, Cambridge Science Park, Cambridge, EENG, CB4 0WD, UK
| | - Julien Taieb
- Department of Gastroenterology & Digestive Oncology, Université de Paris, Hopital Européen Georges-Pompidou, 20, Rue Leblanc, Paris, 75015, France
| | - Joannes Han van Krieken
- Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
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3
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Mineur L, François E, Plassot C, Phelip JM, Miglianico L, Dourthe LM, Bonichon N, Moreau L, Guimbaud R, Smith D, Achille E, Hervé R, Bons JM, Remy S, Faroux R, Villing AL, Mahamat A, Rabbia I, Soulié P, Baumgaertner I, Mathé N, Vazquez L, Boustany R. PREMIUM: A French prospective multicenter observational study of factors impacting on efficacy and compliance to cetuximab treatment in first-line KRAS wild-type metastatic colorectal cancer. PLoS One 2020; 15:e0243997. [PMID: 33347495 PMCID: PMC7752147 DOI: 10.1371/journal.pone.0243997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/01/2020] [Indexed: 11/18/2022] Open
Abstract
Background Cetuximab improves progression-free survival (PFS) and overall survival (OS) in patients with KRAS wild type (wt) metastatic colorectal cancer (mCRC). Few data are available on factors impacting both efficacy and compliance to cetuximab treatment, which is, in combination with chemotherapy, a standard-of-care first-line treatment regimen for patients with KRAS wt mCRC. Patients and methods PREMIUM is a prospective, French multicenter, observational study that recruited patients with KRAS wt mCRC scheduled to receive cetuximab, with or without first-line chemotherapy, as part of routine clinical practice, between October 28, 2009 and April 5, 2012 (ClinicalTrials.gov Identifier: NCT01756625). The main endpoints were the factors impacting on efficacy and compliance to cetuximab treatment. Predefined efficacy endpoints were PFS and safety. Results A total of 493 patients were recruited by 94 physicians. Median follow-up was 12.9 months. Median progression-free survival was 11 months [9.6–12]. In univariate analyses, ECOG performance status (PS), smoking status, primary tumor location, number of metastatic organs, metastasis resectability, surgery, folliculitis, xerosis and paronychia maximum grade, and acne preventive treatment were statistically significant. In multivariate analysis (Hazard Ratios of multivariate stepwise Cox models), ECOG PS, surgery, xerosis and folliculitis were positive prognostics factors for longer PFS. Among all patients, 69 (14%) were non-compliant. In multivariate analysis, no variables were statistically significant. The safety profile of cetuximab was consistent with previous studies. Conclusions ECOG PS <2, surgical treatment performed, and maximum grade xerosis or folliculitis developed were predictive factors of cetuximab efficacy on KRAS wt mCRC patients. Unfortunately, we failed in identifying predictive factors for compliance in these patients.
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Affiliation(s)
- L. Mineur
- Institut Sainte-Catherine, Avignon, France
| | | | - C. Plassot
- Institut Universitaire de Recherche Clinique, Montpellier, France
| | - J. M. Phelip
- Hopital universitaire CHU Nord Saint Etienne, Saint Etienne, France
| | | | | | | | - L. Moreau
- Clinique les Domes, Clermont-Ferrand, France
| | | | - D. Smith
- Hopital Saint-André, Bordeaux, France
| | - E. Achille
- Clinique de l’Orangerie, Strasbourg, France
| | - R. Hervé
- CH Privé Clairval, Marseille, France
| | - J. M. Bons
- Polyclinique Saint-Francois, Desertine, France
| | - S. Remy
- Centre d’Oncologie de la côte Basque, Bayonne, France
| | | | | | | | - I. Rabbia
- Cabinet médical, Orange, Paris, France
| | | | | | - N. Mathé
- Centre Clinique de Soyaux, Soyaux, France
| | - L. Vazquez
- Institut Sainte-Catherine, Avignon, France
- * E-mail:
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4
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Freml J, Delate T, Hermosillo-Rodriguez J. Guideline-recommended incorporation of biomarker testing results in metastatic colorectal cancer therapy. Per Med 2020; 17:185-194. [PMID: 32330071 DOI: 10.2217/pme-2019-0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: To describe pharmacogenomic tumor testing among patients with metastatic colorectal cancer. Methods: This was a retrospective study of patients with metastatic colorectal cancer diagnosed between 1 January 2014 and 30 June 2018. Patients were assessed for pharmacogenomic testing and appropriateness of chemotherapy use. Results: Overall, 112/167 (67.1%) patients had at least one of the three recommended pharmacogenomic tests and 41/167 (24.6%) had all tests. Twenty-four patients were treated with cetuximab with 8/167 (4.7%) identified as being treated with a RAS variant (n = 3) or incomplete testing (n = 5); thus, not in accordance with guidelines. Conclusion: Uptake of testing was variable but increased over time; however, a small proportion of patients received cetuximab with a variant or not all recommended tests being performed.
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Affiliation(s)
- Jared Freml
- Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO 80011, USA.,Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, CO 80453, USA
| | - Thomas Delate
- Pharmacy Department, Kaiser Permanente Colorado, Aurora, CO 80011, USA.,Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, CO 80453, USA
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5
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Kennecke H, Berry S, Maroun J, Kavan P, Aucoin N, Couture F, Poulin-Costello M, Gillesby B. A retrospective observational study to estimate the attrition of patients across lines of systemic treatment for metastatic colorectal cancer in Canada. ACTA ACUST UNITED AC 2019; 26:e748-e754. [PMID: 31896945 DOI: 10.3747/co.26.4861] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Selection and sequencing of treatment regimens for individual patients with metastatic colorectal cancer (mcrc) is driven by maintaining reasonable quality of life and extending survival, as well as by access to and cost of therapies. The objectives of the present study were to describe, for patients with mcrc, attrition across lines of systemic therapy, patterns of therapy and their timing, and KRAS status. Methods A retrospective chart review at 6 Canadian academic centres included sequential patients who were diagnosed with mcrc from 1 January 2009 onward and who initiated first-line systemic treatment for mcrc between 1 January and 31 December 2009. Death was included as a competing risk in the analysis. Results The analysis included 200 patients who started first-line therapy. The proportions of patients who started second-, third-, and fourth-line systemic therapy were 70%, 30%, and 15% respectively. Chemotherapy plus bevacizumab was the most common first-line combination (66%). The most common first-line regimen was folfiri plus bevacizumab. KRAS testing was performed in 103 patients (52%), and 38 of 68 patients (56%, 19% overall) with confirmed KRAS wild-type tumours received an epidermal growth factor receptor inhibitor (egfri), which was more common in later lines. Most KRAS testing occurred after initiation of second-line therapy. Conclusions In the modern treatment era, a high proportion of patients receive at least two lines of therapy for mcrc, but only 19% receive egfri therapy. Earlier KRAS testing and therapy with an egfri might allow a greater proportion of patients to access all 5 active treatment agents.
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Affiliation(s)
- H Kennecke
- Virginia Mason Cancer Institute, Seattle, WA, U.S.A
| | - S Berry
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON
| | - J Maroun
- Medical Oncology, Faculty of Medicine, University of Ottawa, Ottawa, ON
| | - P Kavan
- Department of Oncology, Faculty of Medicine, McGill University, Montreal, QC
| | - N Aucoin
- Hôpital de la Cité-de-la-Santé, Laval, QC
| | - F Couture
- Centre hospitalier universitaire de Québec, Quebec City, QC
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6
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Niu W, Wang G, Feng J, Li Z, Li C, Shan B. Correlation between microsatellite instability and RAS gene mutation and stage III colorectal cancer. Oncol Lett 2018; 17:332-338. [PMID: 30655771 PMCID: PMC6313205 DOI: 10.3892/ol.2018.9611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/25/2018] [Indexed: 02/06/2023] Open
Abstract
Correlation between RAS gene mutation and microsatellite instability (MSI) status in cancer tissues and clinicopathological parameters of patients with stage III colorectal cancer (CRC) were investigated. Tissues were collected from 180 patients diagnosed with stage III CRC in the Department of Gastrointestinal Surgery of the Fourth Hospital of Hebei Medical University from 2012 to 2016. RAS gene mutations in paraffin sections were detected by PCR and Sanger sequencing. Expression of mismatch repair proteins MLH1, MSH2, MSH6 and PMS2 was detected by immunohistochemistry, and MSI status was determined based on the positive and negative expression combinations of the above proteins, and the correlation with clinicopathological parameters of CRC was analyzed. Mutation rates of KRAS and NRAS were 48.33% (87/180) and 2.78% (5/180), respectively. Mutation rate of p.G12D in codon 12 of exon 2 in KRAS gene was the highest (31/87, 35.63%). Mutation rate of p.G12D in codon 12 of exon 2 in NRAS gene was the highest (2/5, 40%). Mutation rate of KRAS gene in right colon was higher than that in left colon and rectum (p<0.05), and mutation rate in N2b phase was higher than that in N2a and N1 phases (p<0.01). In low degree of microsatellite instability (MSI-L) and high degree of microsatellite instability (MSI-H) status, negative MKH1 protein expression was dominant (18/32, 56.25%). MSI-H in CRC patients aged ≥50 years was higher than that of CRC patients <50 years. Rates of MSI-H in N1, N2a, and N2b were 1.75, 12.82, and 1.11% (p<0.05). Mutation rate of KRAS gene in MSI-H status of stage III CRC patients was significantly higher than that in MSI-L/microsatellite stability (MSS) (p<0.05). Mutation of RAS gene and the status of MSI are involved in the occurrence and development of stage III CRC. Detection of RAS gene has important significance for the individual treatment of CRC in clinic.
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Affiliation(s)
- Wenbo Niu
- Department of Surgery Ⅱ, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Guiying Wang
- Department of Surgery Ⅱ, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Jun Feng
- Department of Surgery Ⅱ, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Zheng Li
- Department of Surgery Ⅱ, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Chenhui Li
- Department of Surgery Ⅱ, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Baoen Shan
- Center of Scientific Research, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
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7
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Han van Krieken J, Kafatos G, Bennett J, Mineur L, Tomášek J, Rouleau E, Fabian P, De Maglio G, García-Alfonso P, Aprile G, Parkar P, Downey G, Demonty G, Trojan J. Panitumumab use in metastatic colorectal cancer and patterns of RAS testing: results from a Europe-wide physician survey and medical records review. BMC Cancer 2017; 17:798. [PMID: 29183279 PMCID: PMC5706421 DOI: 10.1186/s12885-017-3740-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 10/31/2017] [Indexed: 12/22/2022] Open
Abstract
Background In Europe, treatment of metastatic colorectal cancer (mCRC) with panitumumab requires prior confirmation of RAS wild-type mutation status. Two studies – a physician survey and a medical records review (MRR) – were conducted to evaluate the use of panitumumab and awareness among prescribing oncologists of the associated RAS testing requirements in clinical practice. Methods Both studies enrolled participants from nine European countries and were carried out in three consecutive rounds. Rounds 1 and 2 (2012–2013) examined KRAS (exon 2) testing only; the results have been published in full previously. Round 3 (2014–2015) examined full RAS testing (exons 2, 3, 4 of KRAS and NRAS) and was initiated following a change in prescribing guidelines, from requiring KRAS alone to requiring full RAS testing. For the physician survey, telephone interviews were conducted with oncologists who had prescribed panitumumab to patients with mCRC in the previous 6 months. For the MRR, oncologists were asked to provide anonymised clinical information, extracted from their patients’ records. Results In Round 3, 152 oncologists and 131 patients’ records were included in the physician survey and MRR, respectively. In Round 3 of the physician survey, 95.4% (n = 145) of participants correctly identified that panitumumab should only be prescribed in RAS wild-type mCRC compared with 99.0% (n = 298) of 301 participants in Rounds 1 and 2, responding to the same question about KRAS testing. In Round 3 of the MRR, 100% (n = 131) of patients included in the study had confirmed KRAS or RAS wild-type status prior to initiation of panitumumab compared with 97.7% (n = 299) of 306 patients in Rounds 1 and 2 (KRAS only). Of those patients in Round 3, 83.2% (n = 109) had been tested for RAS status and 16.8% (n = 22) had been tested for KRAS status only. Conclusions Physicians’ adherence to prescribing guidelines has remained high over time in Europe, despite the change in indication for panitumumab treatment, from KRAS to RAS wild-type mCRC. Additionally, this study demonstrates the uptake of full RAS testing among the majority of oncologists and pathologists. Electronic supplementary material The online version of this article (10.1186/s12885-017-3740-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | - Jiří Tomášek
- Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Pavel Fabian
- Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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8
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Greenbaum A, Wiggins C, Meisner AL, Rojo M, Kinney AY, Rajput A. KRAS biomarker testing disparities in colorectal cancer patients in New Mexico. Heliyon 2017; 3:e00448. [PMID: 29202108 PMCID: PMC5701808 DOI: 10.1016/j.heliyon.2017.e00448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/14/2017] [Accepted: 11/01/2017] [Indexed: 02/07/2023] Open
Abstract
Introduction American Society of Clinical Oncology (ASCO) guidelines recommend that all patients with metastatic colorectal cancer (mCRC) receive KRAS testing to guide anti-EGFR monoclonal antibody treatment. The aim of this study was to assess for disparities in KRAS testing and mutational status. Methods The New Mexico Tumor Registry (NMTR), a population-based cancer registry participating in the National Cancer Institute's Surveillance, Epidemiology and End Results program, was queried to identify all incident cases of CRC diagnosed among New Mexico residents from 2010 to 2013. Results Six hundred thirty-seven patients were diagnosed with mCRC from 2010-2013. As expected, KRAS testing in Stage 4 patients presented the highest frequency (38.4%), though testing in stage 3 (8.5%), stage 2 (3.4%) and stage 1 (1.2%) was also observed. In those with metastatic disease, younger patients (≤ 64 years) were more likely to have had testing than patients 65 years and older (p < 0.0001). Patients residing in urban areas received KRAS testing more often than patients living in rural areas (p = 0.019). No significant racial/ethnic disparities were observed (p = 0.66). No significant differences were seen by year of testing. Conclusion Age and geographic disparities exist in the rates of KRAS testing, while sex, race/ethnicity and the year tested were not significantly associated with testing. Further study is required to assess the reasons for these disparities and continued suboptimal adherence to current ASCO KRAS testing guidelines.
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Affiliation(s)
- Alissa Greenbaum
- Department of Surgery, University of New Mexico, Albuquerque, NM, United States
| | - Charles Wiggins
- New Mexico Tumor Registry, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States.,Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States.,University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, United States
| | - Angela Lw Meisner
- New Mexico Tumor Registry, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States.,University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, United States
| | - Manuel Rojo
- University of New Mexico School of Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Anita Y Kinney
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States.,University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, United States
| | - Ashwani Rajput
- Department of Surgery, University of New Mexico, Albuquerque, NM, United States
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9
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Schmiegel W, Scott RJ, Dooley S, Lewis W, Meldrum CJ, Pockney P, Draganic B, Smith S, Hewitt C, Philimore H, Lucas A, Shi E, Namdarian K, Chan T, Acosta D, Ping-Chang S, Tannapfel A, Reinacher-Schick A, Uhl W, Teschendorf C, Wolters H, Stern J, Viebahn R, Friess H, Janssen KP, Nitsche U, Slotta-Huspenina J, Pohl M, Vangala D, Baraniskin A, Dockhorn-Dworniczak B, Hegewisch-Becker S, Ronga P, Edelstein DL, Jones FS, Hahn S, Fox SB. Blood-based detection of RAS mutations to guide anti-EGFR therapy in colorectal cancer patients: concordance of results from circulating tumor DNA and tissue-based RAS testing. Mol Oncol 2017; 11:208-219. [PMID: 28106345 PMCID: PMC5527457 DOI: 10.1002/1878-0261.12023] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/10/2016] [Accepted: 11/03/2016] [Indexed: 12/22/2022] Open
Abstract
An accurate blood‐based RAS mutation assay to determine eligibility of metastatic colorectal cancer (mCRC) patients for anti‐EGFR therapy would benefit clinical practice by better informing decisions to administer treatment independent of tissue availability. The objective of this study was to determine the level of concordance between plasma and tissue RAS mutation status in patients with mCRC to gauge whether blood‐based RAS mutation testing is a viable alternative to standard‐of‐care RAS tumor testing. RAS testing was performed on plasma samples from newly diagnosed metastatic patients, or from recurrent mCRC patients using the highly sensitive digital PCR technology, BEAMing (beads, emulsions, amplification, and magnetics), and compared with DNA sequencing data of respective FFPE (formalin‐fixed paraffin‐embedded) tumor samples. Discordant tissue RAS results were re‐examined by BEAMing, if possible. The prevalence of RAS mutations detected in plasma (51%) vs. tumor (53%) was similar, in accord with the known prevalence of RAS mutations observed in mCRC patient populations. The positive agreement between plasma and tumor RAS results was 90.4% (47/52), the negative agreement was 93.5% (43/46), and the overall agreement (concordance) was 91.8% (90/98). The high concordance of plasma and tissue results demonstrates that blood‐based RAS mutation testing is a viable alternative to tissue‐based RAS testing.
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Affiliation(s)
- Wolff Schmiegel
- Department of Internal Medicine, Medical University of Bochum Hospital, Germany
| | - Rodney J Scott
- Pathology North, John Hunter Hospital, New Lambton Heights, Australia.,Hunter Medical Research Institute, Newcastle, Australia.,The Faculty of Medicine and Health, University of Newcastle, Australia
| | - Susan Dooley
- Pathology North, John Hunter Hospital, New Lambton Heights, Australia
| | - Wendy Lewis
- Pathology North, John Hunter Hospital, New Lambton Heights, Australia
| | - Cliff J Meldrum
- Pathology North, John Hunter Hospital, New Lambton Heights, Australia
| | - Peter Pockney
- The Faculty of Medicine and Health, University of Newcastle, Australia.,Division of Surgery, John Hunter Hospital, New Lambton Heights, Australia
| | - Brian Draganic
- The Faculty of Medicine and Health, University of Newcastle, Australia.,Division of Surgery, John Hunter Hospital, New Lambton Heights, Australia
| | - Steve Smith
- The Faculty of Medicine and Health, University of Newcastle, Australia.,Division of Surgery, John Hunter Hospital, New Lambton Heights, Australia
| | - Chelsee Hewitt
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - Hazel Philimore
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - Amanda Lucas
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - Elva Shi
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - Kateh Namdarian
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - Timmy Chan
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - Danilo Acosta
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - Su Ping-Chang
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | | | - Anke Reinacher-Schick
- Division of Hematolgy and Oncology, Department of Internal Medicine, St. Josef Hospital, Ruhr-University Bochum, Germany
| | - Waldemar Uhl
- Department of Visceral and General Surgery, St. Josef Hospital, Ruhr-University Bochum, Germany
| | | | - Heiner Wolters
- Department of Visceral and General Surgery, St. Josefs-Hospital, Dortmund, Germany
| | - Josef Stern
- Department of Visceral and General Surgery, St. Josefs-Hospital, Dortmund, Germany
| | - Richard Viebahn
- Department of Visceral and General Surgery, Medical University of Bochum Hospital, Germany
| | - Helmut Friess
- Department of Surgery, University Hospital Klinikum rechts der Isar, Technical University Munich, Germany
| | - Klaus-Peter Janssen
- Department of Surgery, University Hospital Klinikum rechts der Isar, Technical University Munich, Germany
| | - Ulrich Nitsche
- Department of Surgery, University Hospital Klinikum rechts der Isar, Technical University Munich, Germany
| | | | - Michael Pohl
- Department of Internal Medicine, Medical University of Bochum Hospital, Germany
| | - Deepak Vangala
- Department of Internal Medicine, Medical University of Bochum Hospital, Germany.,Department of Molecular GI Oncology, University of Bochum Hospital, Germany
| | | | | | | | - Philippe Ronga
- Global Medical Affairs Oncology, Merck KGAa, Darmstadt, Germany
| | | | - Frederick S Jones
- Medical Scientific Affairs, Sysmex Inostics Inc., Mundelein, IL, USA
| | - Stephan Hahn
- Department of Molecular GI Oncology, University of Bochum Hospital, Germany
| | - Stephen B Fox
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
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