The second edition of NCCN colon cancer guideline in 2020 includes the detection of KRAS, NRAS and BRAF mutations and NTRK fusion in the principle of pathological review, and introduces in detail the clinical significance of RAS, BRAF V600E mutation and NTRK fusion detection.

Objectives: To develop evidence-based guideline recommendations through a systematic review of the&nbsp;literature to establish standard molecular biomarker testing of colorectal cancer (CRC) tissues to guide&nbsp;epidermal growth factor receptor (EGFR) therapies and conventional chemotherapy regimens.</span></p><p style="line-height: 150%"><span style="line-height: 150%; font-size: 14px; font-family: arial, helvetica, sans-serif;">Results: Twenty-one guideline statements were established.</span></p><p style="line-height: 150%"><span style="line-height: 150%; font-size: 14px; font-family: arial, helvetica, sans-serif;">Conclusions: Evidence supports mutational testing for EGFR signaling pathway genes, since&nbsp;they provide clinically actionable information as negative predictors of benefit to anti-EGFR&nbsp;monoclonal antibody therapies for targeted therapy of CRC. Mutations in several of the biomarkers have clear prognostic value. Laboratory approaches to operationalize CRC molecular testing&nbsp;are presented.</span></p>