KRAS Mutation
- Also Known As:
- K-Ras

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At a Glance
Why Get Tested?
To detect a KRAS gene mutation in tumor tissue in order to guide cancer therapy and to evaluate prognosis
When To Get Tested?
When you have colon cancer that has spread (metastatic) or non-small cell lung cancer
Sample Required?
A sample of tumor tissue obtained through a biopsy procedure or sometimes collected during surgery
Test Preparation Needed?
None
What is being tested?
This test detects specific mutations in the KRAS gene in the DNA of cancer cells and tissue. The presence of these mutations may indicate that certain drugs will not be effective in treating the cancer.
KRAS is a short name for the gene Kirsten rat sarcoma viral oncogene homolog. It is one of a group of genes involved in a pathway called the epidermal growth factor receptor (EGFR) pathway. This complex signaling pathway involves numerous components that relay signals from outside of the cell to within the cell to help regulate cell growth, division, survival and death.
In many normal cells, binding of epidermal growth factor (EGF) to its receptor (EGFR) on the surface of the cell is an important signal for cell growth and division. Other signals in the pathway involve a class of proteins called tyrosine kinase (TK) enzymes and a protein produced by the KRAS gene. Normally, the components of the pathway interact in the regulation of cell growth and division and do not individually stimulate cell proliferation.
However, in some cancers, EGFR becomes active even in the absence of EGF, leading to uncontrolled cell growth and division. Drugs that inhibit EGFR or tyrosine kinase enzymes are often helpful for treating such cancers. Some of these cancers, though, have a mutation in the KRAS gene that produces an abnormal K-Ras protein. The abnormal protein is always active and can stimulate cell growth even in the absence of signals from EGFR or other tyrosine kindase proteins. In such cancers, drugs that inhibit EGFR or tyrosine kinases will not be effective.
KRAS is mutated in 15% to 20% of human cancers, mostly in pancreatic cancer, colon cancer and lung cancers as well as leukemias. Approximately 30% to 40% of colon cancers and 15% to 30% of lung cancers have KRAS mutations. Currently, drugs that target EGFR are used to treat colon cancer and non-small cell lung cancer. KRAS mutation testing is used to determine whether these drugs will be effective in treating these cancers.
There are several different methods of testing for KRAS mutations, but all of them involve evaluating the KRAS gene in tumor tissue.
Common Questions
View Sources
Sources Used in Current Review
Current review performed by Hui Li, PhD, DABCC, FACB, FCACB, Clinical Chemist, Dynacare and the Editorial Review Board.
Cicenas J et. al. (2017 April 28). KRAS, TP53, CDKN2A, SMAD4, BRCA1, and BRCA2 Mutations in Pancreatic Cancer. Available online at http://www.mdpi.com/2072-6694/9/5/42. Accessed January 2019.
Chiramel J et. al. (2017 April 26). Targeting the Epidermal Growth Factor Receptor in Addition to Chemotherapy in Patients with Advanced Pancreatic Cancer: A Systematic Review and Meta-Analysis. Available online at http://www.mdpi.com/1422-0067/18/5/909. Accessed January 2019.
Shen et al. (2017 March 07). Diagnostic and prognostic value of blood samples for KRAS mutation identification in lung cancer: a meta-analysis. Available online at http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path[]=15972&pubmed-linkout=1. Accessed January 2019.
Sobani et. al. (2016 Oct 10). Oncogenic fingerprint of epidermal growth factor receptor pathway and emerging epidermal growth factor receptor blockade resistance in colorectal cancer. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056326/pdf/WJCO-7-340.pdf. Accessed January 2019.
Wang JP et. al. (2015 Jul 20). Erlotinib is effective in pancreatic cancer with epidermal growth factor receptor mutations: a randomized, open-label, prospective trial. Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4627242/pdf/oncotarget-06-18162.pdf. Accessed January 2019.
Quest Diagnostics [On-line information]. KRAS Mutation Analysis. Available online at https://www.questdiagnostics.com/testcenter/TestDetail.action?ntc=16510. Accessed January 2019.
Sources Used in Previous Reviews
Lefferts, J. and Tsongalis, G. (2010 March 5). KRAS Mutation Detection: A New Look at an Old Gene. Clinical Chemistry v 56:5, 698–701 [On-line information]. Available online at http://www.clinchem.org/content/56/5/698.full. Accessed May 2012.
Franklin, W. et. al. (2012 January). KRAS Mutation Comparison of Testing Methods and Tissue Sampling Techniques in Colon Cancer. J Mol Diagn. v 12(1): 43–50. [On-line information]. Available online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797717/. Accessed May 2012.
Anderson, S. (2011 August 15). Laboratory Methods for KRAS Mutation Analysis. Medscape Today News from Expert Rev Mol Diagn. v 11(6):635-642 [On-line information]. Available online at http://www.medscape.com/viewarticle/746638. Accessed May 2012.
Markman, M. (Updated 2012 March 28). Colorectal Cancer and KRAS/BRAF. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/1690010-overview. Accessed May 2012.
Pool, M. (2009 March 2). The Role of KRAS Mutation Testing in the Management of Colorectal Cancer. CAP [On-line information]. Available online at www.cap.org. Accessed May 2012.
(2009 July). KRAS Mutation Testing for Anti-Epidermal Growth Factor Receptor Therapy in Colorectal and Lung Cancer. Mayo Clinic Mayo Medical Laboratories Communique [On-line information]. Available online at http://www.mayomedicallaboratories.com/articles/communique/2009/07.html. Accessed May 2012.
(© 1995-2012). Test ID: KRAS KRAS Gene, 7 Mutation Panel, Tumor. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/89378. Accessed May 2012.
Jarboe, E. et. al. (Updated 2011 February). Colorectal Cancer. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/ColorectalCancer.html. Accessed May 2012.
(Reviewed 2012 May). KRAS. Genetics Home Reference [On-line information]. Available online at http://ghr.nlm.nih.gov/gene/KRAS. Accessed May 2012.
(Reviewed 2011 December 7). Tumor Markers. National Cancer Institute [On-line information]. Available online at http://www.cancer.gov/cancertopics/factsheet/Detection/tumor-markers. Accessed May 2012.
Liu, X. et. al. (2011 February 13). KRAS Gene Mutation in Colorectal Cancer is Correlated with Increased Proliferation and Spontaneous Apoptosis. Medscape Today News from Am J Clin Pathol. v 135:245-252. [On-line information]. Available online at http://www.medscape.com/viewarticle/736647. Accessed May 2012.
(Revised 2012 February 17). Lung Cancer (Non-Small Cell), How is non-small cell lung cancer diagnosed? American Cancer Society [On-line information]. Available online. Accessed May 2012.
(Revised 2012 January 25). How is colorectal cancer diagnosed? American Cancer Society [On-line information]. Available online. Accessed May 2012.
(Reviewed 2009 November). KRAS Mutation Analysis. Quest Diagnostics [On-line information]. Available online at http://www.questdiagnostics.com/testcenter/testguide.action?fn=Lung/TS_KRAS.htm. Accessed May 2012.
Chowdhuri, S. et. al. (2012 May 8). EGFR and KRAS Mutation Analysis in Cytologic Samples of Lung Adenocarcinoma Enabled by Laser Capture Microdissection. Medscape Today News from Modern Pathology. v 25(4):548-555 [On-line information]. Available online at http://www.medscape.com/viewarticle/763033. Accessed May 2012.
(Reviewed Sept 7 2012) National Cancer Institute. Targeted Cancer Therapies. Available online at http://www.cancer.gov/cancertopics/factsheet/Therapy/targeted. Accessed September 2012.
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