Historically considered undruggable, KRAS mutations have gained significant attention due to recent KRAS inhibitor clinical trials. KRAS is the most frequently mutated oncogene, occurring in approximately 20-25% of all cancers. The frequency and distribution of KRAS mutations varies depending on the type of cancer, and they are most predominant in pancreatic ductal adenocarcinoma, colorectal cancer, and non-small lung cancer.
KRAS mutations are typically considered prognostic biomarkers, as they are indicative of poor patient outcomes irrespective of treatment. KRAS mutations also commonly occur in a mutually exclusive fashion with other genetic mutations and alterations. Given this, many treatment guidelines recommend including KRAS testing in situations where molecular testing is appropriate.
Do you test for KRAS mutations at diagnosis and what method do you use? If you do not test at initial diagnosis, do you test at relapse? How do these test results play into your decision-making regarding treatment?