Treatment options for stage IV patients in first-line setting included 5 Fluorouracil-based chemotherapy alone (29%), eventually added to a targeted anti-vascular endothelial growth factor (anti-VEGF, 45%) or anti-epidermal growth factor receptor (anti-EGFR, 26%) drugs according to the KRAS/NRAS tumor molecular profile. The gene discussed is NRAS; the disease is neoplasm.