RAS mutation status (KRAS / NRAS exons 2-4)
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | BIO-RAS-MUTATION |
|---|---|
| Тип | Біомаркер |
| Синоніми | Expanded RASKRAS/NRAS extendedRAS mutation statusСтатус мутацій RAS (KRAS / NRAS exons 2-4) |
| Статус | переглянуто 2026-04-26 |
| Хвороби | Не вказано |
| Джерела | SRC-ESMO-COLON-2024 SRC-NCCN-COLON-2025 |
Дані про біомаркер
| Тип біомаркера | gene_mutation |
|---|---|
| Деталі мутації | {"exons": ["KRAS exons 2, 3, 4 (codons 12, 13, 59, 61, 117, 146)", "NRAS exons 2, 3, 4 (codons 12, 13, 59, 61, 117, 146)"], "functional_impact": "activating", "gene": "KRAS, NRAS", "variant_type": "missense (predominantly)"} |
| Вимірювання | MethodNGS panel (preferred) or PCR-based (BEAMing, ddPCR for ctDNA) Unitscategorical: RAS-mutant (any) | RAS-WT (all 6 hotspots WT in both genes) |
| Пов’язані біомаркери | BIO-BRAF-V600E |
Де використовується
Diseases
DIS-THYROID-ANAPLASTIC- Anaplastic thyroid carcinoma (ATC)DIS-THYROID-PAPILLARY- Papillary thyroid carcinoma (PTC)
Indications
IND-CRC-METASTATIC-1L-RAS-WT-LEFT- IND-CRC-METASTATIC-1L-RAS-WT-LEFTIND-CRC-METASTATIC-2L-EGFRI-RECHALLENGE- IND-CRC-METASTATIC-2L-EGFRI-RECHALLENGEIND-CRC-METASTATIC-2L-HER2-AMP-T-DXD- IND-CRC-METASTATIC-2L-HER2-AMP-T-DXDIND-CRC-METASTATIC-2L-HER2-AMP-TUCATINIB- IND-CRC-METASTATIC-2L-HER2-AMP-TUCATINIBIND-CRC-METASTATIC-3L-RECHALLENGE-EGFRI- IND-CRC-METASTATIC-3L-RECHALLENGE-EGFRI
Questionnaires
QUEST-CRC-1L-STUB- Colorectal carcinoma — first line
Біомаркер
BIO-HRAS- HRAS mutationBIO-KRAS-G12D- KRAS G12D mutationBIO-KRAS-G12V- KRAS G12V mutationBIO-NRAS-Q61R- NRAS Q61R mutation
Клінічна застосовність
BMA-KRAS-A146T-CRC- KRAS A146T — rare, anti-EGFR contraindication marker. No targeted therapy.BMA-KRAS-A146T-NSCLC- KRAS A146T in NSCLC — rare; no approved targeted therapy.BMA-KRAS-A146T-PDAC- KRAS A146T in PDAC — rare; no approved targeted therapy.BMA-KRAS-EXON3-CRC- KRAS exon 3 codon 59/61 in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/p...BMA-KRAS-EXON4-CRC- KRAS exon 4 codon 117/146 in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab...BMA-KRAS-G12D-CRC- KRAS G12D in mCRC predicts anti-EGFR resistance. No approved targeted therapy 2026; trial...BMA-KRAS-G12D-ENDOMETRIAL- KRAS G12D in endometrial — common in endometrioid; no approved targeted therapy.BMA-KRAS-G12D-GASTRIC- KRAS G12D in gastric — no approved targeted therapy.BMA-KRAS-G12D-NSCLC- KRAS G12D in NSCLC (~5%) — pan-KRAS / G12D-selective inhibitors in early trials. ICI-base...BMA-KRAS-G12D-OVARIAN- KRAS G12D in mucinous/low-grade serous ovarian — no approved drug; trial-only (MRTX1133).BMA-KRAS-G12D-PDAC- KRAS G12D is the most common PDAC driver (~35-40%). MRTX1133 (Mirati/Bristol) and RMC-980...BMA-KRAS-G12V-CRC- KRAS G12V in mCRC — anti-EGFR contraindication marker, no targeted therapy. Standard chem...BMA-KRAS-G12V-ENDOMETRIAL- KRAS G12V in endometrial — POLE/MMR/p53 subtyping drives 1L.BMA-KRAS-G12V-OVARIAN- KRAS G12V in low-grade serous / mucinous ovarian — no approved targeted therapy.BMA-KRAS-G12V-PDAC- KRAS G12V in PDAC — second-most common driver. No approved drug 2026; pan-KRAS inhibitors...BMA-KRAS-G12X-CRC- KRAS G12 (any) in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/panitumuma...BMA-KRAS-G13D-CRC- KRAS G13D in mCRC — historical signal of partial cetuximab response (De Roock 2010) was n...BMA-KRAS-G13D-NSCLC- KRAS G13D in NSCLC — no approved KRASi; ICI-based therapy per usual algorithm.BMA-KRAS-G13X-CRC- KRAS G13 (any non-G13C) in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/p...BMA-KRAS-Q61-CRC- KRAS Q61 (any) in mCRC — extended-RAS WT criterion fails; anti-EGFR (cetuximab/panitumuma...BMA-KRAS-Q61-MELANOMA- KRAS Q61 (rare in melanoma; NRAS Q61 is more common) — MEKi monotherapy modest activity (...BMA-KRAS-Q61-NSCLC- KRAS Q61 in NSCLC — no approved targeted therapy.BMA-KRAS-Q61-PDAC- KRAS Q61 in PDAC (rare vs G12) — no approved drug; chemo + clinical trial.BMA-NRAS-G12-AML- NRAS G12/G13 in AML — common in pediatric AML and JMML; not directly targeted.BMA-NRAS-G12-CRC- NRAS codon 12 mutation in mCRC — extended RAS WT criterion fails; anti-EGFR contraindicat...BMA-NRAS-G12-MDS-HR- NRAS G12 in MDS-HR — adverse marker. Azacitidine + venetoclax / alloSCT.BMA-NRAS-G12-MDS-LR- NRAS G12 in MDS-LR — progression-risk marker. No targeted therapy; standard MDS-LR care (...BMA-NRAS-G12-MELANOMA- NRAS G12/G13 — rarer than Q61 mutations in melanoma. Same MEKi/ICI rationale extrapolated.BMA-NRAS-G13-AML- NRAS G13 in AML — same rationale.BMA-NRAS-G13-CRC- NRAS codon 13 in mCRC — anti-EGFR contraindicated.BMA-NRAS-G13-MDS-HR- NRAS G13 in MDS-HR — adverse marker. Azacitidine + venetoclax / alloSCT.BMA-NRAS-G13-MDS-LR- NRAS G13 in MDS-LR — progression-risk marker. No targeted therapy; standard MDS-LR care (...BMA-NRAS-G13-MELANOMA- NRAS G13 in melanoma — limited data; treat per NRAS-mut algorithm.BMA-NRAS-Q61K-AML- NRAS Q61K in AML — same as Q61R; no approved targeted agent.BMA-NRAS-Q61K-CRC- NRAS Q61K in mCRC — anti-EGFR contraindication.BMA-NRAS-Q61K-MELANOMA- NRAS Q61K — same therapeutic rationale as Q61R. ICI 1L; binimetinib NEMO subgroup.BMA-NRAS-Q61R-AML- NRAS mutations in AML (~10-15%) — adverse prognostic in some contexts; not directly targe...BMA-NRAS-Q61R-CRC- NRAS Q61R in mCRC — anti-EGFR (cetuximab/panitumumab) contraindication. Standard chemo ±...BMA-NRAS-Q61R-MDS-HR- NRAS in higher-risk MDS — adverse marker; HMA + venetoclax considered, alloSCT preferred.BMA-NRAS-Q61R-MDS-LR- NRAS in MDS — typically signals progression risk to AML. No targeted therapy in MDS-LR; H...- ... 1 ще
Тривожна ознака
RF-CRC-RAS-MUTANT- Metastatic colorectal cancer with KRAS or NRAS hotspot mutation (KRAS exon 2 codons 12/13...