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Test Code RASFP RAS/RAF Targeted Gene Panel by Next-Generation Sequencing, Tumor

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

Additional Tests

Test ID Reporting Name Available Separately Always Performed
SLIRV Slide Review in MG No Yes

Testing Algorithm

When this test is ordered, slide review will always be performed at an additional charge.

Method Name

Polymerase Chain Reaction (PCR)-Based Next Generation Sequencing

Reporting Name

RAS/RAF Panel, Tumor

Specimen Type


Advisory Information

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 from one tissue block) or 5,000 total cells (5,000 total nucleated cells if using cytology slides).

Necessary Information

A pathology report must accompany specimen in order for testing to be performed.

Specimen Required


Specimen Type: Tissue

Container/Tube: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block.



Specimen Type: Tissue

Slides: 1 stained and 10 unstained

Collection Instructions: Submit 1 slide stained with hematoxylin and eosin and 10 unstained, unbaked slides with 5-micron thick sections of the tumor tissue.



Specimen Type: Cytology

Container/Tube: Cytology slide (Direct smears or ThinPrep)

Slides: 1-2 slides (stained and coverslipped) with a minimum of 5,000 total nucleated cells

Collection Instructions: Submit 1-2 slides stained and coverslipped.

Additional Information: Cytology slides will not be returned.

Specimen Minimum Volume

Formalin-fixed, paraffin-embedded (FFPE) tissue block (preferred) or 1 slide stained with hematoxylin and eosin and 8 unstained, nonbaked slides

Specimen Stability Information

Specimen Type Temperature Time
Varies Ambient (preferred)

Clinical 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 Food and Drug Administration (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.


The epidermal growth factor receptor (EGFR) gene product 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.


See Targeted Gene Regions Interrogated by RAS/RAF Gene Panel in Special Instructions for details regarding the targeted gene regions identified by this test.

Reference Values

An interpretive report will be provided.

Day(s) and Time(s) Performed

Monday through Friday; Varies

Analytic Time

12 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

RAS/RAF Targeted Gene Panel by Next Generation Sequencing, Tumor

81210-BRAF (v-raf murine sarcoma viarl oncogene humolog B1) (eg, colon cancer), gene analysis, V600E variant

81275-KRAS (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) (eg, carcinoma) gene analysis, variants in codons 12 and 13

81403-HRAS (v-Ha-ras Harvey rat sarcoma viral oncogene homolog) (eg, Costello syndrome), exon 2 sequence

81404-NRAS (neuroblastoma RAS viral oncogene homolog) (eg, colorectal carcinoma), exon 1 and exon 2 sequence

Slide Review

88381-Microdissection, manual

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RASFP RAS/RAF Panel, Tumor In Process


Result ID Test Result Name Result LOINC Value
36725 Result Summary 50397-9
36726 Result No LOINC Needed
36727 Interpretation 69047-9
36728 Additional Information 48767-8
36729 Specimen 31208-2
36730 Source 31208-2
36731 Tissue ID 81178-6
36732 Released By In Process

NY State Approved



If not ordering electronically, complete, print, and send an Oncology Test Request Form (T729) with the specimen (