Quality standard
Quality statement 3: Testing to guide systemic anti-cancer treatment
Quality statement 3: Testing to guide systemic anti-cancer treatment
Quality statement
Adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment have testing to identify tumours with RAS and BRAF V600E mutations. [new 2022]
Rationale
Predictive biomarkers provide information about the effects of a therapeutic intervention on patient outcomes. They can therefore help to guide treatment decision making. Testing for RAS and BRAF V600E mutations is used to select adults with metastatic colorectal cancer who are most likely to benefit from targeted therapy.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements and clinical protocols to ensure that adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment have testing to identify tumours with RAS and BRAF V600E mutations.
Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example written clinical protocols. The National Bowel Cancer Audit plans to report on RAS and BRAF testing at provider level.
Process
Proportion of adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment who had testing to identify tumours with RAS and BRAF V600E mutations.
Numerator – the number in the denominator who had testing to identify tumours with RAS and BRAF V600E mutations.
Denominator – the number of adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment.
Data source: The National Disease Registration Service collects data on RAS and BRAF testing. The National Bowel Cancer Audit collects patient-level data on the performance of RAS and BRAF V600E tests in stage IV disease.
Outcome
Progression-free survival for adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment.
Data source: No routinely collected national data for this measure has been identified. Data can be collected routinely from information recorded locally by healthcare professionals and provider organisations, for example from patient records.
What the quality statement means for different audiences
Service providers (such as laboratory services) ensure that systems are in place to provide testing to identify tumours with RAS and BRAF V600E mutations in adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment.
Healthcare professionals (such as oncologists) are aware of local referral pathways for testing to identify tumours with RAS and BRAF V600E mutations in adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment.
Commissioners (such as clinical commissioning groups, integrated care systems or NHS England) ensure that they commission services that provide testing to identify tumours with RAS and BRAF V600E mutations in adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment.
Adults with metastatic colorectal cancer suitable for systemic anti-cancer treatment have testing to identify the most beneficial treatment for them.
Source guidance
Colorectal cancer. NICE guideline NG151 (2020, updated 2021), recommendation 1.4.1