Biomarker testing and mutation prevalence in metastatic colorectal cancer patients in five European countries using a large oncology database

Future Oncol. 2021 Apr;17(12):1483-1494. doi: 10.2217/fon-2020-0975. Epub 2021 Jan 19.

Abstract

Background: The literature on biomarker testing for metastatic colorectal cancer (mCRC) in Europe is scarce. This study aimed to estimate the percentage of mCRC patients from five European countries tested for biomarkers over time. Materials & methods: An oncology database was retrospectively analyzed; evaluated biomarkers were RAS, BRAF and microsatellite instability (MSI). The patients were drug treated during 2018 and tested for relevant biomarkers in 2013-2018. Results: RAS testing was conducted in >90% of mCRC patients from 2014 onwards. BRAF testing increased from 31% of mCRC patients in 2013 to 67% in 2018. MSI testing increased from 10 to 41%. There was no notable trend over time for RAS and BRAF mutation or MSI-high prevalence. Conclusion: Biomarker testing among patients diagnosed with mCRC was increased over time. This study demonstrates the quick uptake of biomarker testing in clinical practice. These findings are significant as biomarker-based drugs are becoming more common.

Keywords: BRAF; EGFR; MSI; RAS; biomarker; mCRC; prevalence.

Plain language summary

Lay abstract Each patient’s cancer is unique. To find the best medicine for each patient, doctors perform tests to look at the cancer’s genes. It is unknown how often and how well these tests are done. We tried to find this out for patients with cancer of the bowel or rectum that has spread to other organs. We found that an important genetic test called RAS is done in most patients. Other tests, called BRAF and microsatellite instability, are also conducted increasingly frequently. This is important because the results of such tests allow doctors to decide which drug(s) should be the most effective depending on the patient’s cancer genes.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / genetics*
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / pathology
  • Databases, Factual / statistics & numerical data
  • Europe
  • Female
  • Genetic Testing / statistics & numerical data*
  • Genetic Testing / trends
  • Humans
  • Male
  • Medical Oncology / statistics & numerical data*
  • Medical Oncology / trends
  • Microsatellite Instability
  • Middle Aged
  • Mutation
  • Precision Medicine / methods
  • Precision Medicine / statistics & numerical data
  • Precision Medicine / trends
  • Prognosis
  • Proto-Oncogene Proteins B-raf / genetics
  • Retrospective Studies
  • ras Proteins / genetics

Substances

  • Biomarkers, Tumor
  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf
  • ras Proteins

Grants and funding