For which mutations should patients diagnosed with metastatic CRC be tested?
The typical testing a few years ago was KRAS. That actually is now only part of the testing we should do for patients with metastatic colorectal cancer. Today, every patient should have an all RAS analysis, which includes KRAS and NRAS. The question of whether you add a BRAF analysis to that or not, it should not be routine, but I would suggest that it would be routine when you have capability to do it at your institution. BRAF would not inform you about EGFR, per se, but BRAF may lead you down a therapeutic path with, for example, triplet chemotherapy rather than a doublet chemotherapy plus bevacizumab.
Unresectable Colon Cancer: Case 2
52-year-old woman newly diagnosed with metastatic CRC and is genotyped as part of her initial work up.