Targeted Oncology

, 6:133 | Cite as

Uptake of KRAS mutation testing in patients with metastatic colorectal cancer in Europe, Latin America and Asia

  • Fortunato Ciardiello
  • Sabine Tejpar
  • Nicola Normanno
  • Domenica Mercadante
  • Tracey Teague
  • Bruno Wohlschlegel
  • Eric Van Cutsem
Original Research


The mutation status of the KRAS gene in the tumors of patients with metastatic colorectal cancer (mCRC) is a predictive biomarker for the efficacy of epidermal growth factor receptor monoclonal antibody therapy. The establishment of KRAS mutation testing in this setting represents a significant change to standard diagnostic procedures and a major advance in the personalization of cancer care. Against a changing regulatory background, three cross-sectional surveys of physicians in 14 countries in Europe, Latin America and Asia were conducted in 2008, 2009, and 2010 to investigate the uptake and outcome of KRAS testing for patients with mCRC. Physicians in each year answered questions on four patients (last patient seen and last seen in first-, second- and third-line settings). Fieldwork was carried out February–May 2008, January–April 2009, and January–April 2010. Data from 3,819, 3,740 and 3,820 anonymized, uncoded patient records were collated. The frequency of KRAS testing in patients with mCRC increased from 3% in 2008 to 47% in 2009 and 69% in 2010. The 2010 survey revealed that test results were available within 15 days for 82%, 51% and 98% of the 1679, 679, and 261 tested patients in the European, Latin American and Asian regions, respectively. Cetuximab was the most commonly administered targeted agent in tested patients with KRAS wild-type mCRC (798/1607 patients; 50%) and bevacizumab was the most commonly administered targeted agent in tested patients with KRAS mutant tumors (396/893; 44% overall). In conclusion, KRAS testing is now widely established as a routine diagnostic procedure for patients with mCRC and is used increasingly to guide treatment selection.


KRAS Predictive EGFR Cetuximab Metastatic colorectal cancer mCRC 



The authors take full responsibility for the content of this publication. They would like to thank Dr. Jim Heighway of Cancer Communications and Consultancy Ltd., funded by Merck KGaA, for his contribution to the development of the manuscript, including analysis and interpretation of the survey data and the provision of medical writing services.

Conflict of interest statement

F. Ciardiello, S. Tejpar, N. Normanno, T. Teague and B. Wohlschlegel reported that no funds were received in support of this study or that no benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript. D. Mecadante reported that she has received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript. E. Van Cutsem reported that although he has not received and will not receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript, benefits have been or will be received but are directed solely to a research fund, foundation, educational institution, or other non-profit organization with which he is associated.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Fortunato Ciardiello
    • 1
  • Sabine Tejpar
    • 2
  • Nicola Normanno
    • 3
  • Domenica Mercadante
    • 4
  • Tracey Teague
    • 5
  • Bruno Wohlschlegel
    • 5
  • Eric Van Cutsem
    • 2
  1. 1.Division of Medical Oncology, Department of Experimental and Clinical Medicine and Surgery “F. Magrassi and A. Lanzara”Second University of NaplesNaplesItaly
  2. 2.Digestive Oncology UnitUniversity Hospital GasthuisbergLeuvenBelgium
  3. 3.Cell Biology and Biotherapy UnitINT-Fondazione PascaleNaplesItaly
  4. 4.IMS HealthMilanItaly
  5. 5.Merck KGaADarmstadtGermany

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