Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test
About Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test
| Field | Value |
|---|---|
| Also Known As | Liquid Biopsy PAN RAS Test, cfDNA RAS/BRAF Mutation Panel, Circulating Tumour DNA KRAS/NRAS/BRAF Test, ctDNA RAS Mutation Analysis |
| Sample Type | Peripheral blood (specialised Streck tube) |
| Fasting Required | No fasting required |
| Report Time | 15 days |
| Recommended For | Adults with metastatic colorectal cancer; men and women |
| Price | Starting at ₹30,000 |
What Is a Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test?
The Liquid Bx. Cell-Free PAN RAS test is a specialised blood-based molecular test. It detects mutations in three genes: KRAS, NRAS, and BRAF, by analysing cell-free DNA (cfDNA) circulating in the bloodstream. Also called a Liquid Biopsy PAN RAS Test or ctDNA RAS Mutation Analysis, it is typically ordered for patients with metastatic colorectal cancer. A peripheral blood sample is collected and processed to extract tumour-derived DNA for analysis.
What Does a Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test Measure?
The Liquid Bx. Cell-Free PAN RAS test procedure analyses circulating tumour DNA (ctDNA) released by cancer cells into the blood. The test screens for specific gene mutations that influence treatment decisions.
The following gene targets are assessed:
| Gene | What Is Analysed | Why It Matters |
|---|---|---|
| KRAS | Mutations at codons 12, 13, 59, 61, 117, and 146 | Predicts resistance to anti-EGFR therapies such as cetuximab |
| NRAS | Mutations in exons 2, 3, and 4 | Also predicts resistance to anti-EGFR antibodies |
| BRAF | V600E mutation and other V600 variants | Linked to poor prognosis; may indicate eligibility for BRAF-targeted therapy |
| Cell-free DNA (cfDNA) | DNA fragments shed by tumour cells into the bloodstream | Reflects the genetic make-up of the tumour without a surgical biopsy |
Results are reported as "Detected" or "Not Detected" for each gene, sometimes with a variant allele frequency (VAF) value indicating the proportion of mutant DNA in the sample.
Why Is a Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test Done?
This test helps oncologists understand the genetic profile of a patient's tumour using a simple blood draw, guiding treatment selection for metastatic colorectal cancer.
Common Symptoms That May Require This Test
A doctor may order this test when a patient with known or suspected colorectal cancer presents with the following symptoms:
- Persistent or worsening abdominal pain
- Unexplained weight loss
- Changes in bowel habits lasting several weeks
- Blood in the stool
- Fatigue without a clear cause
- Loss of appetite
Conditions This Test Can Help Detect
This test is used in the context of cancer care rather than initial diagnosis. It helps identify the following:
- KRAS and NRAS mutations that predict resistance to anti-EGFR therapies (cetuximab and panitumumab) in metastatic colorectal cancer
- BRAF V600E mutation, which is associated with a poorer prognosis and potential eligibility for BRAF-targeted treatment combinations
- Emerging resistance mutations during cancer treatment
- Tumour genetic changes that may affect ongoing therapy decisions
Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test for Chronic Disease Monitoring
For patients already receiving cancer treatment, this test can be repeated over time to track how the tumour responds. Serial ctDNA testing provides a non-invasive way to detect treatment resistance, identify new mutations, and flag possible disease recurrence before it becomes visible on imaging. Your oncologist will advise on how frequently retesting is appropriate for your situation.
How to Prepare and What to Expect
The Liquid Bx. Cell-Free PAN RAS test requires no special preparation, but a few practical steps help ensure accurate results.
Do You Need to Fast?
No fasting is required before this test. You may eat and drink normally before your sample is collected.
Practical Tips Before Your Test
The following steps will help the collection go smoothly:
- Bring a detailed clinical history, including your symptoms, previous test results, and relevant medical records, as this is required for the test
- Inform the phlebotomist and your doctor about all current medications, especially any ongoing cancer treatments
- Stay well hydrated before the blood draw, unless your doctor has advised otherwise
- Avoid strenuous physical activity immediately before the sample is collected
Step-by-Step Procedure
The Liquid Bx. Cell-Free PAN RAS test procedure involves the following steps:
- A trained phlebotomist cleans the inside of your arm with an antiseptic wipe to prepare the area.
- A 10 ml peripheral blood sample is drawn from a vein in your arm using a standard needle.
- The blood is collected directly into a specialised Streck tube, which is designed to preserve cell-free DNA and prevent it from degrading.
- The sample is labelled and stored under refrigerated conditions (2 to 8°C) for transport to the laboratory.
- At the laboratory, plasma is separated from the blood, and cell-free DNA is extracted.
- The DNA is analysed using Next-Generation Sequencing (NGS), an advanced technique that reads the DNA sequence to detect mutations in the KRAS, NRAS, and BRAF genes.
Factors That Can Affect Accuracy
The following factors may influence the reliability of your result:
- Tumour burden: lower levels of circulating tumour DNA in early-stage or well-controlled disease can reduce test sensitivity
- Recent chemotherapy or targeted therapy, which may temporarily suppress detectable ctDNA
- Timing between blood draw and plasma separation; delayed processing can degrade cfDNA
- Improper storage or transport temperature
- Use of a standard EDTA tube instead of a specialised cfDNA stabilisation tube
Understanding Your Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test Results
Results from this test are reviewed by your oncologist alongside your clinical history, imaging findings, and overall treatment plan. The table below explains how each result is generally interpreted.
| Gene | Result | General Interpretation |
|---|---|---|
| KRAS | No mutation detected (wild-type) | Patient may be eligible for anti-EGFR therapy |
| KRAS | Mutation detected | Predicts resistance to anti-EGFR antibodies; alternative therapies may be considered |
| NRAS | No mutation detected (wild-type) | Patient may be eligible for anti-EGFR therapy |
| NRAS | Mutation detected | Predicts resistance to anti-EGFR antibodies |
| BRAF | No mutation detected (wild-type) | Not associated with BRAF-specific poor prognosis |
| BRAF V600E | Mutation detected | Indicates poorer prognosis; BRAF-targeted therapy may be considered |
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Test sensitivity is directly related to the amount of circulating tumour DNA in your blood:
- In advanced or active disease, ctDNA levels tend to be higher, making mutations easier to detect. In patients with low tumour burden, early-stage disease, or well-responding tumours, ctDNA may be undetectable.
- A negative result does not always rule out the presence of a mutation; tissue-based testing may be recommended to confirm findings in such cases.
- Recent cancer treatment can also temporarily reduce detectable ctDNA, which may affect result interpretation.
How to Maintain Healthy Levels
While this test does not have "healthy" ranges in the conventional sense, the following general steps support your overall wellbeing during cancer care:
- Follow your oncologist's recommended surveillance and retesting schedule
- Maintain balanced nutrition and appropriate physical activity as advised by your care team
- Attend all follow-up appointments to ensure timely monitoring of your treatment response
Lupin Diagnostics Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test Price and Home Collection
The Liquid Bx. Cell Free PAN RAS test cost at Lupin Diagnostics starts at ₹30,000, and home collection is available across select cities.
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 30000 |
| CHENNAI | 30000 |
| HYDERABAD | 30000 |
| KOLKATA | 30000 |
| NAVI MUMBAI | 30000 |
| PUNE | 30000 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
The Liquid Bx. Cell-Free PAN RAS test online booking process is straightforward:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred time slot.
- Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Home Collection
Home collection for the Liquid Bx. Cell-Free PAN RAS test is available across cities, with samples collected by certified phlebotomists trained in cfDNA handling protocols. All samples are processed in NABL-accredited laboratories to ensure accuracy and reliability. Your digital report will be shared with you via email or WhatsApp once ready.
Frequently Asked Questions
A liquid biopsy is a blood test that detects DNA shed by tumour cells into the bloodstream. Unlike a tissue biopsy, which requires surgery to remove a sample of tumour tissue, the Liquid Bx. Cell-Free PAN RAS test needs only a peripheral blood sample. It is minimally invasive and may better reflect the genetic diversity of the tumour across multiple sites.
International cancer guidelines recommend testing all three genes together because any one of them can predict resistance to anti-EGFR therapies used in metastatic colorectal cancer. Testing them as a panel gives a complete picture and helps oncologists select the most suitable treatment from the start.
A negative result means no mutations were detected in the circulating tumour DNA at the time of testing. This may indicate the patient is eligible for anti-EGFR therapy. However, if clinical suspicion remains, your oncologist may recommend tissue-based testing to confirm, as low tumour burden can sometimes lead to undetectable ctDNA.
The report for this test is typically delivered within 15 days. This reflects the time needed for plasma separation, cfDNA extraction, and next-generation sequencing analysis. Your results will be shared digitally once ready.
There is no fixed universal schedule. Your oncologist will decide on the frequency based on your treatment plan, response to therapy, and clinical condition. Serial testing can help detect emerging resistance mutations and guide timely changes to treatment.
No. The Liquid Bx. Cell-Free PAN RAS test is designed for patients with known or suspected metastatic colorectal cancer to guide treatment decisions. It is not used as a first-line tool to diagnose cancer. A tissue biopsy remains the standard method for an initial cancer diagnosis.
Yes, provided it is performed by a trained phlebotomist using the correct specialised collection tube. The Streck tube used for this test stabilises cell-free DNA and keeps it intact for at least 48 to 72 hours, making home collection safe and practical when handled correctly.
Liquid Bx. Cell-Free PAN RAS (KRAS, NRAS, BRAF) Test
