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25502 RAS/RAF Targeted Gene Panel, Tumor (RASFP)

RAS/RAF Targeted Gene Panel, Tumor (RASFP)
Test Code: RASFPSO
Synonyms/Keywords
Tumor panel, Oncology panel, NRAS, KRAS, HRAS, BRAF
Useful For

Identifying tumors that may respond to targeted therapies by assessing multiple gene targets simultaneously.

Identifying mutations that may help determine prognosis for patients with solid tumors.

Identifying specific mutations within genes known to be associated with response or resistance to specific cancer therapies.

Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)​​
Submit one of the following.
Pathology report must accompany specimen in order for testing to be performed.​ ​ ​ ​ ​ ​ ​
​Tissue ​FFPE tissue block ​Slides 1 H&E slide and 10 unstained nonbaked slides with 5 micron thick sections of the tumor tissue ​1 H&E slide and 10 unstained, non-baked slides with 5 microns thick sections of the tumor tissue ​
​Cytology ​Cytology Slide (Direct smears or ThinPrep) ​ 1-2 slides (stained and coverslipped) with a minimum of 5000 total nucleated cells ​​1 H&E slide and 10 unstained, non-baked slides with 5 microns thick sections of the tumor tissue ​
At least 20% tumor is required for this assay. ​The amount of tissue needed is dependent on a variety of preanalytical factors (eg, cellularity, ischemic time, fixation). In general, the minimum specimen adequacy for this test is approximately a 6 mm(2) area of tissue (can be over multiple slides) or 5000 total cells.
 
If using Cytology slides, minimum specimen requirement is 5000 total nucleated cells.
Cytology slides will not be returned.​ ​ ​ ​ ​
Specimen Stability Information
Specimen Type ​​Temperature
​Varies ​ ​ Ambient (preferred)
​Frozen
​Refrigerated
Rejection Criteria
​Note: No specimen should be rejected. If specimen not received at appropriate temperature or in wrong fixative, include note to laboratory. If questions, contact laboratory.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumen​​tation
​Mayo Medical Laboratories ​Weekly; varies ​12 days ​Next-generation sequencing is performed to test for the presence of a mutation in targeted regions of the following 4 genes: BRAF, HRAS, NRAS, KRAS. See Targeted Gene Regions Interrogated by RAS/RAF Gene Panel in Special Instructions for details regarding the targeted gene regions identified by this test.(Unpublished Mayo method)
Reference Lab
Mayo Clinic Laboratories
Test Information
​Targeted cancer therapies are defined as antibody or small molecule drugs that block the growth and spread of cancer by interfering with specific cell molecules involved in tumor growth and progression. Multiple targeted therapies have been approved by the US FDA for treatment of specific cancers. Molecular genetic profiling is often needed to identify targets amenable to targeted therapies and to minimize treatment costs and therapy-associated risks.
 
Next-generation sequencing has recently emerged as an accurate, cost-effective method to identify mutations across numerous genes known to be associated with response or resistance to specific targeted therapies. The results of this test can be useful for assessing prognosis and guiding treatment of individuals with solid tumors. These data can also be used to help determine clinical trial eligibility for patients with mutations in genes not amenable to current FDA-approved targeted therapies.
 
EGFR is a growth factor receptor that is activated by the binding of specific ligands (epiregulin and amphiregulin), resulting in activation of the RAS/MAPK pathway. Activation of this pathway induces a signaling cascade ultimately regulating a number of cellular processes including cell proliferation. Dysregulation of the RAS/MAPK pathway is a key factor in tumor progression. Targeted therapies directed to EGFR, which inhibit activation of the RAS/MAPK pathway, have demonstrated some success (increased progression-free and overall survival) in patients with colorectal cancer.
 
Assessment for BRAF mutations has clinical utility in that it is a predictor of response to antimutant BRAF therapy. BRAF is a member of the mitogen-activated protein/extracellular signal-regulated (MAP/ERK) kinase pathway, which plays a role in cell proliferation and differentiation. Dysregulation of this pathway is a key factor in tumor progression. Targeted therapies directed to components of this pathway have demonstrated some success with increases both in progression-free and overall survival in patients with certain tumors. Effectiveness of these therapies, however, depends in part on the mutation status of the pathway components.
Reference Range Information
​Interpretive Report
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comme​​nts
81210​ ​ ​1 ​BRAF (v-raf murine sarcoma viarl oncogene humolog B1) (eg, colon cancer), gene analysis, V600E variant ​
​81275 ​ ​1 ​​KRAS (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) (eg, carcinoma) gene analysis, variants in codons 12 and 13 ​
​81403 ​ ​1 ​HRAS (v-Ha-ras Harvey rat sarcoma viral oncogene homolog) (eg, Costello syndrome), exon 2 sequence ​
​81311 ​ ​1 ​
​88381 ​ ​1 ​Microdissection, manual ​
Synonyms/Keywords
Tumor panel, Oncology panel, NRAS, KRAS, HRAS, BRAF
Ordering Applications
Ordering Application Description
COM​​ ​RAS/RAF Targeted Gene Panel
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)​​
Submit one of the following.
Pathology report must accompany specimen in order for testing to be performed.​ ​ ​ ​ ​ ​ ​
​Tissue ​FFPE tissue block ​Slides 1 H&E slide and 10 unstained nonbaked slides with 5 micron thick sections of the tumor tissue ​1 H&E slide and 10 unstained, non-baked slides with 5 microns thick sections of the tumor tissue ​
​Cytology ​Cytology Slide (Direct smears or ThinPrep) ​ 1-2 slides (stained and coverslipped) with a minimum of 5000 total nucleated cells ​​1 H&E slide and 10 unstained, non-baked slides with 5 microns thick sections of the tumor tissue ​
At least 20% tumor is required for this assay. ​The amount of tissue needed is dependent on a variety of preanalytical factors (eg, cellularity, ischemic time, fixation). In general, the minimum specimen adequacy for this test is approximately a 6 mm(2) area of tissue (can be over multiple slides) or 5000 total cells.
 
If using Cytology slides, minimum specimen requirement is 5000 total nucleated cells.
Cytology slides will not be returned.​ ​ ​ ​ ​
Specimen Stability Information
Specimen Type ​​Temperature
​Varies ​ ​ Ambient (preferred)
​Frozen
​Refrigerated
Rejection Criteria
​Note: No specimen should be rejected. If specimen not received at appropriate temperature or in wrong fixative, include note to laboratory. If questions, contact laboratory.
Useful For

Identifying tumors that may respond to targeted therapies by assessing multiple gene targets simultaneously.

Identifying mutations that may help determine prognosis for patients with solid tumors.

Identifying specific mutations within genes known to be associated with response or resistance to specific cancer therapies.

Reference Range Information
​Interpretive Report
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumen​​tation
​Mayo Medical Laboratories ​Weekly; varies ​12 days ​Next-generation sequencing is performed to test for the presence of a mutation in targeted regions of the following 4 genes: BRAF, HRAS, NRAS, KRAS. See Targeted Gene Regions Interrogated by RAS/RAF Gene Panel in Special Instructions for details regarding the targeted gene regions identified by this test.(Unpublished Mayo method)
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comme​​nts
81210​ ​ ​1 ​BRAF (v-raf murine sarcoma viarl oncogene humolog B1) (eg, colon cancer), gene analysis, V600E variant ​
​81275 ​ ​1 ​​KRAS (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) (eg, carcinoma) gene analysis, variants in codons 12 and 13 ​
​81403 ​ ​1 ​HRAS (v-Ha-ras Harvey rat sarcoma viral oncogene homolog) (eg, Costello syndrome), exon 2 sequence ​
​81311 ​ ​1 ​
​88381 ​ ​1 ​Microdissection, manual ​
For most current information refer to the Marshfield Laboratory online reference manual.