KRAS mutations testing in colorectal carcinoma patients in Italy: from guidelines to external quality assessment.

Abstract

BACKGROUND:

Monoclonal antibodies directed against the epidermal growth factor receptor (EGFR) have been approved for the treatment of patients with metastatic colorectal carcinoma (mCRC) that do not carry KRAS mutations. Therefore, KRAS testing has become mandatory to chose the most appropriate therapy for these patients.

METHODOLOGY/PRINCIPAL FINDINGS:

In order to guarantee the possibility for mCRC patients to receive an high quality KRAS testing in every Italian region, the Italian Association of Medical Oncology (AIOM) and the Italian Society of Pathology and Cytopathology -Italian division of the International Academy of Pathology (SIAPEC-IAP) started a program to improve KRAS testing. AIOM and SIAPEC identified a large panel of Italian medical oncologists, pathologists and molecular biologists that outlined guidelines for KRAS testing in mCRC patients. These guidelines include specific information on the target patient population, the biological material for molecular analysis, the extraction of DNA, and the methods for the mutational analysis that are summarized in this paper. Following the publication of the guidelines, the scientific societies started an external quality assessment scheme for KRAS testing. Five CRC specimens with known KRAS mutation status were sent to the 59 centers that participated to the program. The samples were validated by three referral laboratories. The participating laboratories were allowed to use their own preferred method for DNA extraction and mutational analysis and were asked to report the results within 4 weeks. The limit to pass the quality assessment was set at 100% of true responses. In the first round, only two centers did not pass (3%). The two centers were offered to participate to a second round and both centers failed again to pass.

CONCLUSIONS:

The results of this first Italian quality assessment for KRAS testing suggest that KRAS mutational analysis is performed with good quality in the majority of Italian centers.

• Authors: Nicola Normanno, Carmine Pinto, Francesca Castiglione, Alberto Bardelli, Marcello Gambacorta, Gerardo Botti, Oscar Nappi, Salvatore Siena, Fortunato Ciardiello, Gianluigi Taddei, Antonio Marchetti
• Journal: PloS one (PLoS One) Vol. 6 Issue 12 Pg. e29146 ( 2011) ISSN: 1932-6203 [Electronic] United States
• PMID: 22216189 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2011 Normanno et al.

Topics

• Colorectal Neoplasms (genetics)
• Genes, ras
• Genetic Testing (methods)
• Humans
• Italy
• Mutation
• Polymerase Chain Reaction
• Practice Guidelines as Topic
• Quality Control