• 作者：Samuel Navarro ; Pedro P¨¦rez-Segura ; Santiago Ram¨®n y Cajal ; Ram¨®n Salazar ; Jes¨²s Garc¨ªa-Foncillas ; Eva Musul¨¦n Palet ; Roc¨ªo Garc¨ªa-Carbonero ; Artemio Pay¨¢ ; Pilar Garc¨ªa-Alfonso
• 关键词：Receptor del factor de crecimiento epid&eacute ; rmico ; Gen KRAS ; Gen BRAF ; Inestabilidad de microsat&eacute ; lites ; Gen PTEN
• 刊名：Revista Espa?ola de Patolog¨ªa
• 出版年：2012
• 出版时间：July-September, 2012
• 年：2012
• 卷：45
• 期：3
• 页码：130-144
• 全文大小：464 K

This consensus is a joint initiative of the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM). Based on scientific evidence of the use of biomarkers, it recommends diagnostic and treatment guidelines for the management of patients with hereditary, localised and advanced colorectal carcinoma (CRC). The aim of the consensus is to improve healthcare and the use of resources, which will result in increased patient benefit.

Taking into consideration data currently available, the group of experts recommends testing for microsatellite instability in patients with localised CRC, as this is a strong predictive factor useful in deciding the choice of adjuvant treatment. However, although the ColoPrint^? and Oncotype Dx^? gene expression signatures have been shown to have prognostic value, no consensus yet exists as to their clinical use.

For advanced CRC, it is essential to test for KRAS mutation status before administering an anti-epidermal growth factor receptor (EGFR) treatment, such as cetuximab or panitumumab. However, at present, testing for other biomarkers, such as BRAF, EGFR, PI3K and PTEN mutations, is not indicated as a routine procedure as it does not influence choice of treatment. Other important issues addressed include organisational requirements, necessary quality controls for the correct testing of these biomarkers as well as the pertinent legal implications.