Utilization of KRAS mutation status testing in stage IV colorectal cancer (CRC) patients in the United States: National Cancer Data Base (NCDB) analysis.

Abstract

e15172 Background: KRAS mutation status is considered a predictive biomarker of personalized treatment in advanced stage CRC. Its testing is recommended by the National Comprehensive Cancer Network guidelines for stage IV CRC, since it determines the benefit of addition of anti-epidermal growth factor receptor therapy in wild-type KRAS CRC. Data on utilization of the test in the clinical practice across the US are lacking. Methods: Utilization of KRAS testing across the US is presented in a retrospective observational study of NCDB patients (pts) from 2010-2014. Demographics of stage IV CRC pts with recorded KRAS results were analyzed using frequency statistics and logistic regression analysis. Results: 479399 pts had CRC, 93514 (19.5%) were stage IV. 57208/93514 pts with known KRAS testing status entered our study. Mean age was 63.3 years; 51.2% were males. Only 33% (18867/57208) of stage IV CRC pts underwent KRAS testing. Testing was significantly ( p<.001) influenced by pts age and socioeconomic status but not by race or facility type in which pts were treated (Table 1 - see adjusted odds ratio [AOR] and 95% CI). Conclusions: KRAS testing of stage IV CRC pts is underutilized in the US. Impact of its underutilization on outcomes of these pts requires further study. [Table: see text]