RAS/RAF Pathway Mutation Profile (KRAS and NRAS reflex to BRAF)

CPT: 81275; 81276; 81311; 81479; 88381
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Test Details

Synonyms

  • BRAF
  • KRAS
  • NRAS

Use

KRAS and NRAS are guanosine triphosphate (GTP)-binding proteins involved in downstream receptor signaling, which is critical for cell proliferation, survival and differentiation. Mutations in the KRAS and NRAS oncogene are frequently found in human cancers. They are common in pancreatic, colorectal, lung, bile duct, and thyroid cancer, as well as in melanomas. BRAF is an important member of the mitogen-activated protein kinase (MAPK) pathway that influences cell proliferation. Mutations in the BRAF oncogene are frequently found in human cancers, such as melanoma, colorectal cancer, lung cancer, ovarian cancer, thyroid cancer, and hairy cell leukemia. This assay detects KRAS and NRAS mutations in exons 2, 3, and 4, BRAF V600 mutations, allowing the determination of drug response.

Limitations

This assay is able to detect 5% mutation in a background of wild-type DNA.

This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA).

Methodology

SNaPshot Multiplex PCR (primer extension-based method)

Specimen Requirements

Specimen

Formalin-fixed, paraffin-embedded (FFPE) tissue block or slides

Volume

Formalin-fixed, paraffin-embedded (FFPE) tissue block or eight unstained slides and one matching H&E-stained slide at 5 μM

Minimum Volume

Four unstained slides at 5 μM and one matching H&E-stained slide

Container

Formalin-fixed, paraffin-embedded (FFPE) tissue blocks or slides

Storage Instructions

Room temperature

Causes for Rejection

Tumor block containing insufficient tumor tissue; broken or stained slides

Clinical Information

Special Instructions

Provide a copy of the pathology report; the RAS/RAF test will be delayed if the pathology report is not received. Direct any questions regarding this test to customer service at 1-800-345-4363.

References

NCCN Clinical Practice Guidelines in Oncology: Colon Cancer v2. 2017.
NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer v2. 2017.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
481468 RAS/RAF reflex to BRAF 481469 KRAS Results: 21702-6
481468 RAS/RAF reflex to BRAF 481108 KRAS Nucleotide Change: 48004-6
481468 RAS/RAF reflex to BRAF 481109 KRAS Amino Acid Change: 48005-3
481468 RAS/RAF reflex to BRAF 481470 NRAS Results: 21719-0
481468 RAS/RAF reflex to BRAF 481119 NRAS Nucleotide Change: 48004-6
481468 RAS/RAF reflex to BRAF 481129 NRAS Amino Acid Change: 48005-3
481468 RAS/RAF reflex to BRAF 481092 Indications: 42349-1
481468 RAS/RAF reflex to BRAF 481094 Specimen Location: N/A
481468 RAS/RAF reflex to BRAF 481095 Specimen Type: 31208-2
481468 RAS/RAF reflex to BRAF 481096 Block Number: N/A
481468 RAS/RAF reflex to BRAF 481097 Background: 77202-0
481468 RAS/RAF reflex to BRAF 481098 Methodology: 49549-9
481468 RAS/RAF reflex to BRAF 481099 References: 75608-0
481468 RAS/RAF reflex to BRAF 481087 Director Review: 72486-4
481468 RAS/RAF reflex to BRAF 481471 Reflex N/A
481468 RAS/RAF reflex to BRAF 480903 Microdissection Performed 8100-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481031 Results: 58483-9
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481032 Indications: 42349-1
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481033 Specimen Location: N/A
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481034 Specimen Type: 31208-2
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481035 Block #: N/A
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481076 Nucleotide Change: 48004-6
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481079 Amino Acid Change: 48005-3
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481036 Background: 77202-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481065 Methodology: 49549-9
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481059 References: 75608-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481081 Director Review: 72486-4
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 480903 Microdissection Performed 8100-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481181 Referring Physician 18781-5
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481182 Treating Physician N/A
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481183 Body Site 39111-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481168 Client Specimen ID N/A
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481172 Specimens Received N/A
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481173 Clinical Data 55752-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481175 Interpretation 51968-6
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481176 Analytical Results 53844-7
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481177 Comments 77202-0
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481178 Signed By 19139-5
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481179 Disclaimers N/A
Reflex Table for Reflex
Order Code Order Name Result Code Result Name UofM Result LOINC
Reflex 1 481030 BRAF Gene Mutation Analysis 481180 PDF 51969-4

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