An evaluation of RAS testing among metastatic colorectal cancer patients in the USA

Laura Sangaré; Kimberly Delli-Zotti; Ana Florea; Marko Rehn; Al B Benson; Kimberly A Lowe

doi:10.2217/fon-2020-1075

An evaluation of RAS testing among metastatic colorectal cancer patients in the USA

Future Oncol. 2021 May;17(13):1653-1663. doi: 10.2217/fon-2020-1075. Epub 2021 Feb 25.

Authors

Laura Sangaré¹, Kimberly Delli-Zotti², Ana Florea³, Marko Rehn², Al B Benson⁴, Kimberly A Lowe⁵

Affiliations

¹ SimulStat, Portland, OR 97219, USA.
² Amgen, Thousand Oaks, CA 91320, USA.
³ Department of Medicine, University of Arizona, Tucson, AZ 85724, USA.
⁴ Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA.
⁵ Center for Observational Research, One Amgen Center Drive, Thousand Oaks, CA 91320, USA.

PMID: 33629919
DOI: 10.2217/fon-2020-1075

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.

Keywords: KRAS; NRAS; RAS; anti-EGFR; metastatic colorectal cancer; panitumumab.

MeSH terms

Adult
Antineoplastic Combined Chemotherapy Protocols / pharmacology
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Colorectal Neoplasms / drug therapy*
Colorectal Neoplasms / genetics
Colorectal Neoplasms / mortality
Colorectal Neoplasms / pathology
DNA Mutational Analysis / statistics & numerical data
Databases, Factual / statistics & numerical data
Female
GTP Phosphohydrolases / genetics
Genetic Testing / statistics & numerical data*
Humans
Liver Neoplasms / drug therapy*
Liver Neoplasms / genetics
Liver Neoplasms / mortality
Liver Neoplasms / secondary
Longitudinal Studies
Male
Membrane Proteins / genetics
Middle Aged
Molecular Targeted Therapy / methods
Neoplasm Staging
Precision Medicine / methods
Precision Medicine / statistics & numerical data*
Progression-Free Survival
Proto-Oncogene Proteins p21(ras) / genetics
Retrospective Studies
United States / epidemiology

Substances

KRAS protein, human
Membrane Proteins
GTP Phosphohydrolases
NRAS protein, human
Proto-Oncogene Proteins p21(ras)