Abstract 4672
Background
KRAS, NRAS and BRAF mutation testing for metastatic colorectal cancer (mCRC) is essential to guide treatment and prognostication. Multiple gene profiling assays are available, each with differing tumour sample size/quality requirements and turnaround time (TAT). Many UK hospitals send samples to off-site labs for profiling. A rapid TAT is desirable to plan appropriate chemotherapy +/- biologics from cycle one, as well as providing certainty and satisfaction for patients and clinicians.
Methods
This study was conducted at 2 UK tertiary cancer centres (University College London Hospital and Mount Vernon Hospital), comparing a pathway where gene profiling of mCRC was performed off-site using an NGS platform versus on-site testing using the Idylla platform (Biocartis, Mechelen, Belgium). Up to 50 patients were included in each group with 8 of the Idylla tests being used for samples that had failed with the NGS platform.
Results
Mutational profiling results for the whole cohort that were successfully tested (n = 84) showed 26% (22/84) were wildtype for KRAS/NRAS/BRAF, 62% (52/84) KRAS mutated, 2% (2/84) NRAS mutated, 10% (8/84) BRAF mutated. The median TAT in days (median, interquartile range (IQR)) of the on-site Idylla pathway was shorter than the off-site NGS pathway (4, 1 - 6 vs. 15, 13-17; p = <0.0001). In the off-site group median time from request to receipt of sample was 3 days (IQR 2 - 5) and median time from receipt to result was 10 days (IQR 9 - 13). Test failure rate was significantly higher with the NGS test (30%, 15/50) compared to the Idylla test (2%, 1/50) (p = 0.0001). 8 samples that had failed testing with the NGS platform, due to insufficient/low quality of sample, were all successfully tested with the Idylla platform.
Conclusions
For gene profiling of mCRC, on-site testing with the Idylla platform significantly shortened the TAT, lowered failure rate and was able to test more sub-optimal samples compared to off-site NGS testing. Updated results integrating these data with tumour location, MMR status and treatment outcomes will be presented at ESMO 2019.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Biocartis provided the Idylla test kits for this study without charge.
Disclosure
N. Bhuva: Honoraria (self), supported in attending international meetings: Amgen; Honoraria (self), supported in attending international meetings: Bristol-Myers Squibb. K. Shiu: Honoraria (self), Advisory / Consultancy, supported in attending lectures and conferences: Roche; Honoraria (self), Advisory / Consultancy, supported in attending lectures and conferences: Merck Group; Honoraria (self), Advisory / Consultancy, supported in attending lectures and conferences: Servier; Honoraria (self), Advisory / Consultancy, supported in attending lectures and conferences: Guardant Health. All other authors have declared no conflicts of interest.
Resources from the same session
3905 - Loss of CDX-2 expression is an independent poor prognostic biomarker in colorectal cancer
Presenter: Krittiya Korphaisarn
Session: Poster Display session 2
Resources:
Abstract
3963 - Robot-assisted natural orifice specimen extraction surgery for radical resection of colorectal cancer
Presenter: Zhengchuan Niu
Session: Poster Display session 2
Resources:
Abstract
3989 - Bevacizumab as adjuvant treatment for colon cancer: Updated results from the AVANT phase III Study by the GERCOR Group
Presenter: Thierry André
Session: Poster Display session 2
Resources:
Abstract
4741 - Real world data on adjuvant chemotherapy for high-risk stage II colorectal cancer – the role of tumor side
Presenter: Camila Araujo de Carvalho
Session: Poster Display session 2
Resources:
Abstract
4973 - Oncological Outcome and Safety of Bevacizumab (BV) Therapy in Patients with Occlusive Colon Cancer and Self-Expandable Metal Stents (SEMS)
Presenter: Vilma Pacheco-Barcia
Session: Poster Display session 2
Resources:
Abstract
2295 - Active chronic hepatitis B increases the risk of liver metastasis of colorectal cancer- a retrospective clinical study of 7187 consecutive cases of newly diagnosed colorectal cancer
Presenter: Lei Zhao
Session: Poster Display session 2
Resources:
Abstract
3845 - Comprehensive Evaluation of Recurrence Risk (CERR) Score for Colorectal Liver Metastases: Development and Validation
Presenter: Wei Ye
Session: Poster Display session 2
Resources:
Abstract
1976 - BRAF-mutated colorectal metastases: what is the benefit of liver surgery? Results from a cohort of 91 patients.
Presenter: Sahir Javed
Session: Poster Display session 2
Resources:
Abstract
2688 - The smallest colorectal liver metastasis size as a prognosis factor after laparoscopic liver resection
Presenter: Baptiste Cervantes
Session: Poster Display session 2
Resources:
Abstract
4961 - Validation of GAME score risk groups in resected colorectal cancer liver metastases and the prognostic relevance of KRAS, NRAS and BRAF mutation analysis
Presenter: Berta Martin-Cullell
Session: Poster Display session 2
Resources:
Abstract