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Background  Treatment options for patients with metastatic colorectal cancer (mCRC) include anti-epithelial growth factor therapies, which, in Europe, are indicated in patients with  RAS  wild-type tumours only and require prior mutation testing of “hot-spot” codons in exons 2, 3 and 4 of  KRAS  and  NRAS . The aim of this study was to evaluate the implementation of  RAS  testing methods and estimate the  RAS  mutation prevalence in mCRC patients.    Methods  Overall, 194 pathology laboratories were invited to complete an online survey. Participating laboratories were asked to provide information on their testing practices and aggregated  RAS  mutation data from 20 to 30 recently tested patients with mCRC.    Results  A total of 96 (49.5 %) laboratories across 24 European countries completed the survey. All participants tested  KRAS  exon 2, codons 12 and 13. Seventy (72.9 %) laboratories reported complete testing of all  RAS  hot-spot codons, and three (3.1 %) reported only testing  KRAS  exon 2. Sixty-nine (71.9 %) laboratories reported testing >80 patients yearly for  RAS  mutation status. Testing was typically performed within the reporting institution (93.8 %,  n  = 90), at the request of a treating oncologist (89.5 %,  n  = 85); testing methodology varied by laboratory and by individual codon tested. For laboratory  RAS  testing, turnaround times were ≤10 working days for the majority of institutions (90.6 %,  n  = 87). The overall crude  RAS  mutation prevalence was 48.5 % (95 % confidence interval: 46.4–50.6) for laboratories testing all  RAS  hot-spot codons. Prevalence estimates varied significantly by primary tumour location, approximate number of patients tested yearly and indication given for  RAS  testing.    Conclusion  Our findings indicate a rapid uptake of  RAS  testing in the majority of European pathology laboratories.

bmc cancer

RAS testing practices and RAS mutation prevalence among patients with metastatic colorectal cancer: results from a Europe-wide survey of pathology centres