KRAS - Ordering the test

MOUNT SINAI SERVICES provides K-ras mutation detection assay on paraffin block tissue samples (standard material used in the post-operative analysis of tumour samples).

The first step is to send an order for K-ras Mutation Detection to MSS with information about the patient and the diagnostic surgical procedure. This will allow us to contact the original pathology lab to obtain tissue blocks.

After receiving the tumour tissue, DNA extraction and K-ras Mutation Detection will be started immediately. Please refer to the Process Flow diagram for an overview of the process from online requisition entry to final reporting for K-ras Mutation Detection.

1. Requisition Form 
If you need a standard requisition form for patients who will receive Vectibix™ or Erbitux®, please enter all information on-line on this requisition form, and then print and fax to the number on the form.

Please do not use hospital or lab requisitions because MSS requisitions contain required information not provided through regular requisitions.

2. Working with the Requisition
Please open the MSS requisition for K-ras Mutation Detection, type in the information for all fields, print the requisition and have the oncologist sign. A signed requisition form is required to initiate testing. Please also send a copy of the original pathology report along with the requisition. Having the original pathology report makes it easier to obtain the proper tissue and speeds up the test turn-around-time. Please fax these documents to 416-586-4508.

If you have any question, or concerns, please contact us directly by e-mail or by phone at 416-586-4800 ext. 2626.

2. Sending the Requisition to MOUNT SINAI SERVICES
After the oncologist signs off on the requisition, please fax it to the number provided on the form.

3. Access to Tissue Block Samples by Referring Oncologist
If you are sending the request from the same hospital in which the surgery was done and you have access to tissue blocks, please send the tissue block samples with your signed requisition to MSS which will help accelerate the process.

4. Transportation of Blocks
MSS will request tissue blocks from the original pathology laboratory. The pathology lab can use any of the following pathways for sending the tissue samples to MSS.

1. Contact Hospital-In-Common Laboratories (www.hicl.on.ca) during regular office hours (8:30 AM to 5:00 PM) at 416-391-1499, ext. 248. For customer service, please contact Janet Darwin at info@hicl.on.ca. HICL will manage the pick up and drop off schedule for the blocks through Purolator.
   
   Please package the tissue block and consult request form as shown in Fig.2 and make sure the label on the envelope indicates the information as required. Please note that the biohazard bag has the pathology label indicating the patient information and lab ID.
   
   Fig. 2
   

2. Cost of shipping tissue blocks will be covered by MSS. Please call 416-586-4800 ext. 2626 for the FedEx account information.

MSS will return the tissue blocks to the original lab once K-ras Mutation Detection is complete.

Cost Recovery
Presently, the cost of K-ras Mutation Detection will be covered by Amgen if the patient is a candidate for panitumumab (Vectibix™), and by Bristol-Myers Squibb Canada if the patient is a candidate for cetuximab (Erbitux®).

We are investigating other sources to cover the cost of K-ras Mutation Detection. Please contact us if you have a patient that requires K-ras Mutation Detection, but is not a candidate for Vectibix™ or Erbitux®.