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We provide reflex NRAS mutation status testing on all KRAS wild-type samples for patients with metastatic colorectal cancer.
This service is FREE to all NHS customers from CPA accredited laboratories.
We test for KRAS and NRAS mutations in codons 12, 13, and 61. All samples received undergo pathology review to assess tumour burden and samples are enriched by macro-dissection if required.
The RAS family of proteins are encoded by three closely related genes; HRAS, KRAS, and NRAS. These three genes are mutated in approximately 20% of human tumours, although mutations in KRAS account for 85% of these.
While KRAS mutations are common in cancers of the pancreas, colon and lung, mutations of the NRAS gene occur more frequently in melanoma and myeloid leukaemias.
Acquired mutations of the NRAS gene are found in approximately 20% of melanomas. These mutations, all of which activate their protein product constitutively, occur in codons 12, 13, and 61, those of codon 61 being by far the most frequent.
The cellular consequences of activating mutations of NRAS are well understood; constitutive activation of the MAPK and PI3K/AKT pathways leads to melanoma growth and progression. However; the clinical significance of the presence of NRAS mutations in melanomas remains unclear.