210P - Review of the Current Status of Kras Mutation Testing in France in 2011: The Flash-Kras Study

Abstract

ABSTRACT Background KRAS testing is required before treatment initiation of cetuximab in the management of metastatic colorectal cancer (mCRC). The objective of the study was to examine the current situation in 2011 regarding KRAS testing in the initial management of mCRC. Methods This observational, retrospective, national study was carried out between March 28th and April 8th 2011. During this period 538 patients with mCRC were included across 160 french hospitals. The main objective was to assess the rate of KRAS testing in patients who had started first line (L1) treatment for mCRC. The secondary objectives were to describe the time taken and techniques used for KRAS testing, the possible reasons this test was not requested, to describe and analyse the clinical characteristics of the patients and the planned L1 treatments and those finally received. Results KRAS testing was carried out for 433 patients (81.1%) and not carried out for 101 patients (18.9%). The main reasons for not requesting the KRAS status were (several answers possible): anti-EGFR not prescribed (n = 58), candidate for surgery (n = 8), samples not useable (n = 5), age of the patient (n = 3), other (n = 24), data missing (n = 13). The genotyping results were available after a mean delay of 23.6 ± 28.2 days. The KRAS testing was requested by an oncologist (45.5%), a gastroenterologist (31%), a surgeon (11.2%), a pathologist (7.2%) or a multidisciplinary group (5.1%) approximately 15 days (-66.5;33.6) median (min; max) after the diagnosis of metastases, and 15 days (-66.9;3.7) median (min; max) before the start of L1 treatment. Result of KRAS status had not been received before the L1 treatment was chosen in 56.6% of the patients. For patients with wild-type KRAS status whose therapeutic management was modified after the result of KRAS testing (n = 108), this change was a prescription of an anti-EGFR in 77.8% of the cases. Conclusion The Flash-KRAS study is the first one to assess the current modalities of KRAS genotyping in France. It shows that in 2011 the KRAS test is an integral part of the management of patients with mCRC. Nonetheless, it shows disparities between regions in terms of time to obtain results, which need to be improved to be compatible with the therapeutic management. Disclosure M. Ducreux: Merck Serono. A. Lievre: Merck Serono. P. Artru: Merck Serono. M. Guiu: Merck Serono. J. Merlin: Merck Serono. J.C. Sabourin: Merck Serono. J. Viguier: Merck Serono. A. Seronde: Merck Serono. P. Laurent-Puig: Merck Serono. All other authors have declared no conflicts of interest.