1312P Prognostic impact of KRAS status in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitor monotherapy

Pelizzari, Giacomo; Corvaja, Carla; Targato, Giada; Buriolla, Silvia; Bortolot, M.; Torresan, Sara; Fantin, Alberto; Maglio, Giovanna De; Rossetto, C.; Rizzato, Simona; Fasola, Gianpiero; Follador, A.

doi:10.1016/j.annonc.2021.08.1914

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“…Recent studies have reported an association between PD-L1 status and ICI efficacy in patients with KRAS alterations, but no significant association between KRAS mutational subtypes and ICI efficacy. 10,18,30,31 The biology of these patients was categorized into three groups by cooccurring genetic alterations with different immunogenic profiles and responses to ICI. 32,33 We confirmed the evident favorable clinical efficacy of the first-line ICI in these patients (KRAS G12C mutations and KRAS non-G12C mutations).…”

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confidence: 99%

Efficacy of first‐line immune checkpoint inhibitors in patients with advanced NSCLC with KRAS, MET, FGFR, RET, BRAF, and HER2 alterations

et al. 2022

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Background: In patients with non-small cell lung cancer (NSCLC) harboring driver alterations, the efficacy of immune checkpoint inhibitors (ICIs) remains uncertain. Our study aimed to examine the first-line ICI efficacy in patients with NSCLC harboring KRAS, MET, FGFR, RET, BRAF, and HER2 alterations in a real-world setting. Methods: This single-center, retrospective cohort study included patients with advanced NSCLC harboring KRAS, MET, FGFR, RET, BRAF, HER2 alterations or driver-negative, and were treated with first-line ICI therapy. Best overall response, progression-free survival (PFS), and overall survival (OS) were evaluated. Results: Seventy-eight patients with NSCLC were included (median age, 72 years): 67% were men, 15% were never-smokers, and 83% had adenocarcinoma. The driver alterations involved KRAS (n = 21), MET (n = 6), FGFR (n = 3), RET (n = 2), BRAF (n = 2), HER2 (n = 1), and driver-negative (n = 43). The partial responses for KRAS, MET, FGFR, RET, BRAF, HER2, and driver-negative were 57%, 50%, 100%, 50%, 100%, 0%, and 47%, respectively. The median PFS (months) was 16.2 (95% confidence interval [CI]: 6.3-not reached [NR]) for KRAS, 2.8 (95% CI: 2.7-NR) for MET, 11.7 (95% CI: 5.9-NR) for other alterations (FGFR, RET, BRAF, and HER2), and 10.0 (95% CI: 3.7-14.3) for driver-negative, respectively. The median OS (months) was 31.3 (95% CI: 9.0-NR) for KRAS, not reached for MET, 23.5 (95% CI: 18.3-NR) for other alterations, and 21.1 (95% CI: 15.2-NR) for driver-negative, respectively. Conclusions: The benefit of the first-line ICI was similar in advanced NSCLC regardless of the driver alterations, except for MET alterations.

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