Pronostic role of KRAS mutation in colorectal cancer

The management of patients with advanced or localized colorectal cancer (CRC) remains to date exclusively based on clinical, radiological and pathologic data. In CCR, KRAS mutations are detected in approximately 30-40% of tumours. In patients with a localized CRC, the prognostic role of KRAS mutation is not yet demonstrated with contradictory results in literature. For patients with metastatic CCR, KRAS mutations are a prognosis value for patients treated by anti-EGFR antibody. Indeed, despite the use of monoclonal antibodies against epidermal growth factor receptor (EGFR) in metastatic CRC, the detection of molecular alterations in tumours is not integrated in the routine practice for patient decision-making. In patients treated with anti-EGFR Abs for a metastatic CRC, the detection of KRAS mutations on tumour DNA is now mandatory since several recent Studies have clearly demonstrated that the presence of KRAS Mutations confer a resistance to these therapies. Considering the lack of sufficient data, the detection of KRAS mutations is not recommended in other clinical setting.