SNFGE SNFGE
 
Thématique :
- Cancer colorectal (CCR)
Originalité :
Très original
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Sylvain MANFREDI
Coup de coeur :
 
 
Digestive and Liver Disease
  2018/05  
 
  2018 May;50(5):507-512.  
  doi: 10.1016/j.dld.2017.12.029  
 
  RAS mutation testing in patients with metastatic colorectal cancer in French clinical practice: A status report in 2014  
 
  Lièvre A, Merlin JL, Sabourin JC, Artru P, Tong S, Libert L, Audhuy F, Gicquel C, Moureau-Zabotto L, Ossendza RA, Laurent-Puig P, Ducreux M  
  https://www.ncbi.nlm.nih.gov/pubmed/29396127  
 
 

Abstract

BACKGROUND:

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).

AIMS:

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.

PATIENTS AND METHODS:

Observational retrospective study conducted from June to September 2014 in all consecutive patients with newly diagnosed mCRC.

RESULTS:

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.

CONCLUSION:

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.

 

 
Question posée
 
Analyse des pratiques de recherche des mutations RAS chez les patients porteurs de cancers colorectaux métastatiques en France.
 
Question posée
 
85 % des patients ont la recherche de mutation avant la 1ère cure, et dans 91% des cas RAS sauvage un traitement anti-EGFR est instauré. Les délais de rendu des résultats peuvent être améliorés.
 
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