Doctor 2New tests to help doctors know whether bowel cancer treatments are likely to work have come a step closer to NHS funding in England, according to webmd.

For some people with advanced or metastatic bowel cancer, a genetic mutation called KRAS oncogene means they won't respond well to some treatments. Knowing this means they can avoid treatments which won’t help but may have caused unpleasant side effects.

The draft guidance has been welcomed by Bowel Cancer UK.

Bowel cancer

  • Bowel cancer, also called colorectal cancer, is the third most common cancer in the UK with around 40,000 people diagnosed with the condition each year.
  • Bowel cancer is also the second most common cause of cancer death in the UK.
  • Fewer than 7% of people with metastatic bowel cancer survive for longer than 5 years.
Treating bowel cancer
  • Metastatic bowel cancer means the cancer has spread from the colon or rectum to other parts of the body, such as the liver.
  • Around half of all people diagnosed with bowel cancer have metastatic disease.
  • Up to 60% of patients who have undergone surgery for early stage bowel cancer will eventually develop advanced disease and metastases, most often in the liver.
  • KRAS mutation
  • Between 35% and 40% of advanced bowel cancers have a mutation in the KRAS cancer causing gene. This makes the cancer more aggressive affecting the person's chances of surviving the cancer.
  • Tumours with this mutation do not respond to treatment with the chemotherapy drug cetuximab.
  • Knowing that cetuximab won't work means its toxic side effects can be avoided and other approaches taken.

NHS laboratories in England already use a range of tests to identify the KRAS mutations, but there's been no agreement about which ones should be used.
In draft guidance, The National Institute for Health and Care Excellence (NICE) is recommending NHS funding for:

  • Therascreen KRAS RGQ PCR Kit (Qiagen)
  • KRAS LightMix Kit (TIBMolBiol)
  • Pyrosequencing of codons 12, 13 and 61
  • MALDI-TOF (matrix-assisted laser desorption ionization time-of-flight) mass spectrometry of codons 12, 13 and 61.