Why KRAS testing

By Cristiano Antonino On Jan 5, 2023

The KRAS test (human homologue of the Kirsten Rat sarcoma 2 viral oncogene) is the first genetic test to identify the characteristics of an important biomarker of colorectal cancer, the KRAS protein

In tumour cells, this protein is an indispensable mediator of stimuli that promote tumour development, helping to activate cell proliferation, promote the growth of blood vessels that ‘feed’ the tumour (angiogenesis) and reduce programmed cell death of the tumour cell (apoptosis).

Consequently, the analysis of the functional properties of this protein by means of the test allows the use of specific biological drugs capable of blocking its activity and thus controlling tumour development.

In tumours, the gene that ‘governs’ the synthesis of the KRAS protein (the KRAS gene), can be ‘normal’ (KRAS wild-type), or mutated, i.e. with a partly different structure.

If the gene is normal, the KRAS protein produced is perfectly functional and its activity is finely regulated by a complex series of biochemical reactions.

If, on the other hand, the gene is mutated, it gives rise to an ‘abnormal’ KRAS protein that is always active and can no longer be regulated.

What the KRAS test looks for

The KRAS test is used to identify the type of the KRAS gene and, therefore, the status or form of the KRAS protein in colorectal cancer, whether normal (also called ‘wild type’) or ‘non-normal’ (mutated).

This determination is essential precisely because the status of the KRAS protein can influence the prognosis of the disease and the response to those treatments aimed at its inactivation: tumours that present the normal KRAS protein, the vast majority of cases, can be effectively treated with drugs that block its activity, while if the KRAS protein is mutated the oncologist will choose the most appropriate treatment, capable of ensuring maximum benefit.

What the KRAS test identifies

The KRAS test, which has been available since 2007, is a simple, precise and non-invasive test: in most cases, it can be easily performed on already available tumour tissue, e.g. that derived from tumour biopsy, and its results are available within a short time, about a week.

The KRAS gene test therefore analyses the DNA of tumour cells already available from tissue samples already taken by biopsy and other analyses.

The presence of a mutated KRAS gene in tumour cells is detected by a very sensitive and specific method, quantitative PCR (qPCR), which allows the DNA of the KRAS gene to be selectively amplified.

This test is carried out by doctors and biologists in the analysis laboratories of many healthcare facilities.

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