The positive concordance rate for the subset of patients underwent tissue biopsy testing (n = 116), was 63% (n = 50/80) for KRAS mutation, 68% (n = 43/63) for TP53 mutation, 26% (n = 5/19) for SMAD4, and 80% (n = 8/10) for CDKN2A in metastatic disease. This evidence concerns the gene SMAD4 and metastatic neoplasm.