Metastatic colorectal cancer and the use of RAS biomarker testing
ECPC is pleased to have been involved on the 24th of March 2015 in the launch of a new awareness campaign ‘Get Tested’. The Get Testedcampaignaims to raise awareness and understanding of the importance of RAS biomarker testing in patients who are newly diagnosed with metastatic colorectal cancer (mCRC), and to encourage them to discuss testing with their doctor.
The Campaign also presented a White Paper to Members of the European Parliament and European Commission representatives calling for improved access to testing for patients newly diagnosed with metastatic colorectal cancer (mCRC) and for the routine use of RAS biomarker testing in establishing a personalized cancer care plan.
The White Paper, co-authored by ECPC, can be accessed by clicking here.
Colorectal cancer, also known as bowel cancer, is the third most common cancer in men and the second most common in women worldwide. In 2012 more than 694,000 people died from the disease.1 In advanced stage, or metastatic, the primary tumour in the colon or rectum has spread (metastasised) to other parts of the body, commonly to the liver or lungs, making it more difficult to treat and this is known as metastatic colorectal cancer (mCRC). Survival rates for mCRC are low, with only 10–12% of patients surviving 5 years after diagnosis.2,3 Recent analyses of clinical data, however, have indicated that the selection of anti-epidermal growth factor receptor (EGFR) therapy, can improve survival rates for those mCRC patients whose tumours do not have RAS mutations4–7 with data showing survival rates of over 30 months.8–9 In recognition of the advancement that RAS testing has provided for the management of mCRC, treatment guidelines have been updated in both Europe and USA to recommend that all patients with mCRC undergo a RAS mutation status test before the use of anti-EGFR therapy.9,10
A biomarker test is a simple way of looking at the type and status of particular genes of interest in a cancer.11,12 Biomarkers have been found for many different types of cancer, such as colorectal, breast and lung, and have an increasingly important role in helping physicians to tailor care and treatment for their patients − termed 'personalised medicine'.11–13 RAS − a predictive biomarker − is the collective name for the group of genes that includes KRAS and NRAS and can be used to help select the most appropriate therapy for each individual mCRC patient.4–8
In mCRC, RAS has been identified as a key biomarker that can help predict how well mCRC patients may respond to particular treatments, making it important to know their RAS status as early as possible. Approximately half of patients with mCRC have RAS wild-type tumours and half have RAS mutant tumours.14
This initiative was supported by Merck.
However, the content was not influenced by its funder, with ECPC maintaining full editorial control.
- Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. GLOBOCAN 2012 V1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available at: http://globocan.iarc.fr. Last accessed January 2015.
- Sanoff HK, et al. J Clin Oncol. 2008;26(35):5721–7.
- National Cancer Institute. SEER Stat Fact Sheets – Colon and Rectum Cancer. Available at: http://seer.cancer.gov/statfacts/html/colorect.html#survival. Last accessed January 2015.
- Schwartzberg LS, et al. J Clin Oncol. 2014;32(21):2240–7.
- Douillard J-Y, et al. N Engl J Med. 2013;369(11):1023–34.
- Van Cutsem E, et al. J Clin Oncol. 2015:33(3).
- Stintzing S, et al. European Cancer Congress 2013: Abstract No:LBA17.
- Ciardiello F, et al. Oral presentation at the 2014 American Society of Clinical Oncology Annual Meeting, May 30–June 3, 2014.
- Venook AP, J Clin Oncol. 2014:32:5s (suppl; abstr LBA3).
- Bekaii-Saab T. J Natl Compr Canc Netw. 2014;12(2):299–300.
- Van Cutsem E, et al. Ann Oncol. 2014;25(Suppl 3):iii1–iii9.
- Moorcraft SY, et al. Therap Adv Gastroenterol. 2013;6(5):381–95.
- Ong FS, et al. Expert Rev Mol Diagn. 2012;12(6):593–602.
- Mallman MR, et al. EPMA J 2010;1(3):421–37.