Comparison of real-life data from patients with NGS panel negative and KRAS mutation positive metastatic lung adenocarcinoma

Abstract

Objective: To evaluate clinical and demographic characteristics and the results of cytotoxic treatments of KRASG12C, KRASother, and next-generation sequencing (NGS) panel negative patients. Methods: NGS data of 1264 patients with non-small cell lung cancer were retrospectively evaluated. Among these patients, the mutation distributions of 1081 patients with metastatic lung adenocarcinoma were analyzed. A total of 150 patients with negative NGS panel or mutant KRAS followed up in our clinic were included. Clinical features, overall survival, first-line chemotherapy responses, and progression-free survival of NGS panel negative, KRASG12C, and KRASother groups were compared. Results: In 1081 patients who underwent NGS from tumor tissue with the diagnosis of metastatic lung adenocarcinoma, 296 (27%) NGS panel negative and 276 (26%) KRAS mutant patients were detected. Among these patients, 150 patients whose data were available were 71 (47.3%) NGS panel negative, 54 (36%) KRASother, and 25 (16.7%) KRASG12C. Clinical features, brain metastasis, and first-line chemotherapy response were similar among groups. Bone metastases were detected more often in the NGS panel negative group ( p = 0.03). The median follow-up was 8.4 months. Overall, 107 deaths had occurred at the time of analysis. There was no difference in overall survival ( p = 0.56) or progression-free survival ( p = 0.71) among NGS panel negative, KRASother, and KRASG12C patients. Conclusion: There is no difference in overall survival, first-line chemotherapy response, or progression-free survival among patients with NGS panel negative, KRASG12C, or KRASother metastatic lung adenocarcinoma. Bone metastases were observed more frequently in the NGS panel negative group.

KRAS Mutations in Solid Tumors: Characteristics, Current Therapeutic Strategy, and Potential Treatment Exploration

“…Another study of ICIs treating NSCLC patients with high programmed death ligand 1 (PD-L1) expression showed that the KRAS mutation status had no significant impact on the efficacy or safety of ICIs, though with a non-significant trend of worse survival in patients with KRAS G12C mutations [ 40 ]. A real-world study with 150 lung adenocarcinoma patients reported no significant difference in the PFS, OS, as well as first-line chemotherapy response among patients with or without KRAS mutations [ 41 ]. In conclusion, KRAS mutations may not have a significant impact on the prognosis of NSCLC patients.…”