What is the American Society for Clinical Pathology (ASCP), the College of American Pathologists (CAP), the Association for Molecular Pathology (AMP), and the American Society of Clinical Oncology (ASCO) guidelines for gene mutation testing in colon can..

Updated: Apr 15, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

In 2015, the American Society for Clinical Pathology (ASCP), the College of American Pathologists (CAP), the Association for Molecular Pathology (AMP), and the American Society of Clinical Oncology (ASCO) issued a provisional clinical opinion regarding gene mutation testing to predict response to anti–epidermal growth factor receptor (EGFR)  monoclonal antibody (MoAb) therapyin patients with metastatic colorectal carcinoma (mCRC). Among the recommendations are the following [166] :

  • RAS mutational testing of colorectal carcinoma tissue should be performed in a Clinical Laboratory Improvement Amendments–certified laboratory for patients who are being considered for anti-EGFR therapy

  • Analysis should include KRAS and NRAS codons 12 and 13 of exon 2; 59 and 61 of exon 3; and 117 and 146 of exon 4.

  • Anti-EGFR MoAb therapy (currently cetuximab and panitumumab) should only be considered for treatment of patients with mCRC who are identified as having tumors with no mutations detected after extended RAS mutation analysis


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