Hitting the Mark
New US guidelines for colorectal cancer testing highlight the importance of molecular markers
Draft guidelines designed to address the evaluation of molecular markers in colorectal cancer (CRC) have been released by a partnership of US pathology and oncology societies (1). The group hopes that the multidisciplinary guidance will provide useful recommendations on everything from sample collection to diagnostics and follow up, with a stated aim of improving and optimizing personalized care for patients.
Sponsored by the American Society for Clinical Pathology (ASCP), the College of American Pathologists (CAP), the Association for Molecular Pathology (AMP), and the American Society of Clinical Oncology (ASCO), each society was represented by a co-chair. A panel of over 25 different experts in oncology and pathology was also involved – a truly collective effort.
So why were the guidelines needed? “While other CRC guidelines have been published, they tend to focus on one marker or a small panel of markers for one specific clinical use, unlike the collaborative multidisciplinary approach for this guideline,” says Stanley Hamilton, the CAP co-chair of the project. “This guideline addresses all current molecular markers that can impact treatment decisions for patients with CRC. To date, there isn’t an evidence-based guideline that’s quite as all-encompassing and patient-centered as this one.”
The document provides guidance for pathologists on which molecular markers to use for which patients (see Table 1), as well as recommendations on appropriate sampling and testing methods, turnaround times, and test prioritization.
Table 1. Recommendations made by the ASCP/CAP/AMP/ASCO guidelines on which molecular marker tests should be performed on patients with CRC.
The draft guidelines were made available online from March 30 to April 22, 2015, in order to allow comments from the healthcare community, with feedback welcomed.
The guidelines also acknowledged testing methods still under development; “Given the rapid evolution of the field, we have ‘future proofed’ the document with a research section that acknowledges molecular markers and tests on the horizon. We intend to review these recommendations regularly,” says ASCO co-chair, Carmen Allegra.
- American Society for Clinical Oncology, “ASCP, CAP, AMP, and ASCO Issue Draft Colorectal Cancer Molecular Marker Testing Guideline and Announce Opening of Public Comment Period”, (2015). Accessed April 16, 2015.
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