Recommendations from the EGAPP Working Group: Can Testing of Tumor Tissue for Mutations in EGFR Pathway Downstream Effector Genes in Patients with Metastatic Colorectal Cancer Improve Health Outcomes by Guiding Decisions Regarding Anti-EGFR Therapy?

This recommendation statement explores the use of pharmacogenomic testing of tumour in patients with metastatic colorectal cancer to predict response to anti-EGFR antibody therapy (cetuximab or panitumumab). The guideline reviews analytic and clinical validity of testing for selected pharmacogenomic tests including codon 12 and 13 mutations in KRAS, the BRAF V600E mutation, variants in NRAS and in PIK3CA, and loss of PTEN and AKT protein expression. Outcomes of interest include overall or progression-free survival and treatment-related adverse events.