NRAS Mutational Analysis
Description
NRAS is a signaling intermediate in the growth receptor pathway. Certain NRAS mutations predict poor response to anti-EGFR therapy in patients with metastatic colorectal cancer. KRAS (NAACCR Data Item # 3866) and NRAS are important signaling intermediates in the growth receptor pathway, which controls cell proliferation and survival. Both KRAS and NRAS may be constitutively activated through mutation during colorectal carcinogenesis so that they continuously stimulate cell proliferation and prevent cell death (reference AJCC 8, pg. 266). KRAS and NRAS mutations predict poor response to anti-EGFR therapy in patients with metastatic colon cancer. AJCC 8 estimates that KRAS may be activated in up to 40% and NRAS in about 7% of colorectal carcinomas.Notes
**Note 1:** **Effective years** * This SSDI is effective for diagnosis years 2021+ * For cases diagnosed 2018-2020, this SSDI must be blank **Note 2:** **Physician Statement** * Physician statement of NRAS can be used to code this data item when no other information is available. **Note 3:** **Applicable stages** * NRAS may be recorded for all stages; however, it is primarily performed for patients with metastatic disease. If information is not available, code 9. **Note 4:** **Results from nodal or metastatic tissue** * Results from nodal or metastatic tissue may be used for NRAS. **Note 5:** **Neoadjuvant Therapy** * Record the assay from tumor specimens prior to neoadjuvant therapy. * If neoadjuvant therapy is given and there are no NRAS results from pre-treatment specimens, report the findings from post-treatment specimens.Code | Description |
---|---|
0 | Normal NRAS negative; NRAS wild type Negative for (somatic) mutations, no alterations, no (somatic) mutations identified, not present, not detected |
1 | Abnormal (mutated)/detected in codon(s) 12, 13, and/or 61 |
2 | Abnormal (mutated)/detected, codon(s) specified but not in codon(s) 12, 13, or 61 |
4 | Abnormal (mutated), NOS, codon(s) not specified |
7 | Test ordered, results not in chart |
8 | Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 8 may result in an edit error.) |
9 | Not documented in medical record NRAS not assessed or unknown if assessed |
<BLANK> | Must be blank if diagnosis year is before 2021 |