Turkish Journal of Gastroenterology
Original Article

Middle East and North Africa Registry to Characterize Rate of RAS Testing Status in Newly Diagnosed Patients with Metastatic Colorectal Cancer


Department of Medical Oncology, University Center of Beni Messous, Algiers, Algeria


Department of Medical Oncology, Center Pierre & Marie Curie, Algiers, Algeria


Department of Medical Oncology, University Center of Blida, Blida, Algeria


GI Oncology Department, Kuwait Cancer Control Center, Sabah Health Region, Kuwait


Department of Medical Oncology, Zagazig University Faculty of Medicine, Zagazih, Al-Sharkeyya, Egypt


Department of Medical Oncology, King Fahad Medical City Hospital, Comprehensive Cancer Center, Riyadh, Kingdom of Saudi Arabia


Department of Medical Oncology, Public Hospital of Rouiba, Algiers, Algeria


Department of Medical Oncology, Cancer Center of Oran, Messerghine, Algeria


Department of Medical Oncology, Alexandria University Faculty of Medicine, Alexandria, Egypt


Department of Oncology, AMGEN Maghreb, Algiers, Algeria


Department of Oncology, Hematology & Nephrology, AMGEN (Middle East), Dubai, United Arab Emirates

Turk J Gastroenterol 2023; 34: 118-127
DOI: 10.5152/tjg.2022.22106
Read: 836 Downloads: 253 Published: 01 February 2023

Background: Rat sarcoma virus mutational status guides first-line treatment in metastatic colorectal cancer. This study was a multicenter, multi-country ambispective, observational study in the Middle East and North Africa assessing regional rat sarcoma virus testing practices in newly diagnosed patients.

Methods: The retrospective arm (2011-2014) included adults with metastatic colorectal cancer who had initiated first-line therapy with ≥1 post-baseline visit and survival data. The prospective arm (2014-2019) enrolled newly diagnosed patients with histologically proven metastatic colorectal cancer with ≥1 measurable lesion per Response Evaluation Criteria in Solid Tumors, and tissue availability for biomarker analysis. Data look-back and follow-up were 2 years; the rate of RAS mutation was evaluated.

Results: RAS testing was ordered for patients in retrospective (326/417) and prospective (407/500) studies. In the former, testing was typically prescribed after first-line treatment initiation, significantly more in patients with stage IV disease (P < .005), resulting in the addition of targeted therapy (41.8% anti-epidermal growth factor receptor, 30.2% anti-vascular endothelial growth factor) in wild-type metastatic colorectal cancer, and significantly impacted the treatment of left-sided tumors (P = .037). In the latter, 58.4% were RAS wild-type; 41.6% were RAS mutant. Non-prescription of RAS testing was attributed to test unavailability, financial, or medical reasons; predictors of testing prescription were older age, primary tumor in ascending colon, and high tumor grade. RAS status knowledge resulted in the addition of anti-vascular endothelial growth factor (20.4%) or anti-epidermal growth factor receptor therapy (21.2%).

Conclusion: Before 2014, RAS testing in patients with colorectal cancer in the Middle East and North Africa was often performed after first-line treatment. Testing is more routine in newly diagnosed patients, potentially shifting early treatment patterns

Cite this article as: Oukkal M, Bouzid K, Bounedjar A, et al. Middle East and North Africa registry to characterize rate of RAS testing status in newly diagnosed patients with metastatic colorectal cancer. Turk J Gastroenterol. 2023;34(2):118-127.

EISSN 2148-5607