The mutation status of the KRAS gene in the tumors of patients with metastatic colorectal cancer (mCRC) is a predictive biomarker for the efficacy of epidermal growth factor receptor monoclonal antibody therapy. The establishment of KRAS mutation testing in this setting represents a significant change to standard diagnostic procedures and a major advance in the personalization of cancer care. Against a changing regulatory background, three cross-sectional surveys of physicians in 14 countries in Europe, Latin America and Asia were conducted in 2008, 2009, and 2010 to investigate the uptake and outcome of KRAS testing for patients with mCRC. Physicians in each year answered questions on four patients (last patient seen and last seen in first-, second- and third-line settings). Fieldwork was carried out February-May 2008, January-April 2009, and January-April 2010. Data from 3,819, 3,740 and 3,820 anonymized, uncoded patient records were collated. The frequency of KRAS testing in patients with mCRC increased from 3% in 2008 to 47% in 2009 and 69% in 2010. The 2010 survey revealed that test results were available within 15 days for 82%, 51% and 98% of the 1679, 679, and 261 tested patients in the European, Latin American and Asian regions, respectively. Cetuximab was the most commonly administered targeted agent in tested patients with KRAS wild-type mCRC (798/1607 patients; 50%) and bevacizumab was the most commonly administered targeted agent in tested patients with KRAS mutant tumors (396/893; 44% overall). In conclusion, KRAS testing is now widely established as a routine diagnostic procedure for patients with mCRC and is used increasingly to guide treatment selection.

No abstract

Merck KGaA is a global Science and Technology company, focusing on the Healthcare Industry, Life Science and Performance Materials. Merck in Portugal is a relatively small subsidiary with a midsized office employing approximately 114 employees. Merck S.A. Portugal focuses mainly on the Healthcare Market. As the company went through a major transformation in 2016, it created a need to communicate on a low cost basis and in an efficient way, using digital as its main channel. The current paper shows the implementat io n of an employee advocacy strategic plan as a solution to digital communication. Employee Advocacy is a new communications concept derived from employee social media usage and employee word of mouth. It has been noted that employee networks are wider than company's own, and employee word of mouth is more trustworthy. Before the tool could be implemented a research on what motivates employees to commit to Brand Citizens hip Behavior was performed. Findings revealed that in the case of Merck S.A. Portugal employees individual internal drive and brand knowledge are factors affecting willingnes s to share on social media. Based on the results a series of internal strategies were applied onand offline.