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01-04-2013 | Thoracic Oncology

KRAS Mutation in Patients with Lung Cancer: A Predictor for Poor Prognosis but Not for EGFR-TKIs or Chemotherapy

Authors: Ji-lin Guan, MD, Wen-zhao Zhong, MD, She-juan An, PhD, Jin-ji Yang, MD, Jian Su, PhD, Zhi-hong Chen, PhD, Hong-hong Yan, PhD, Zhi-yong Chen, MD, Zhi-min Huang, MD, Xu-chao Zhang, PhD, Qiang Nie, MD, Yi-long Wu, MD

Published in: Annals of Surgical Oncology | Issue 4/2013

Abstract

Background

The prognostic and predictive value of KRAS mutations in patients with lung cancer is controversial. Biases in disease stage, treatment regimen, small-scale patient studies, and biomarker status have led to inconsistent results in previous reports.

Methods

The KRAS and EGFR genes were examined in 1935 consecutive patients with non-small cell lung cancer. All patients were divided into KRAS mutation (KRAS group), EGFR mutation (EGFR group), and KRAS/EGFR wild type (WT group) groups. Randomly selected cases were paired with patients with the KRAS mutation, the EGFR mutation, and KRAS/EGFR wild type patients according to tumor, node, metastasis stage, time of first visit within 1 year, and pathology. Progression-free survival (PFS) and overall survival were evaluated by Kaplan–Meier and Cox models.

Results

The KRAS mutation rate for lung adenocarcinoma was 5.90 %. The overall survival was 14.47, 20.57, and 42.73 months for the KRAS group, WT group, and EGFR group, respectively (P < 0.001). Multivariate analysis indicated that KRAS mutation status was an independent prognostic factor (hazard ratio 2.69, 95 % confidence interval 1.91–3.80, P < 0.001). No difference was found in PFS and tumor responsiveness between patients with a KRAS mutation and those with wild type KRAS/EGFR for chemotherapy and EGFR tyrosine kinase inhibitors (TKI). PFS did not significantly differ for chemotherapy among the three groups (P = 0.270).

Conclusions

KRAS mutation is a poor prognosis factor, but it is not an independent predictor of response to EGFR-TKI or chemotherapy in patients with lung cancer.

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Title: KRAS Mutation in Patients with Lung Cancer: A Predictor for Poor Prognosis but Not for EGFR-TKIs or Chemotherapy
Authors: Ji-lin Guan, MD
Wen-zhao Zhong, MD
She-juan An, PhD
Jin-ji Yang, MD
Jian Su, PhD
Zhi-hong Chen, PhD
Hong-hong Yan, PhD
Zhi-yong Chen, MD
Zhi-min Huang, MD
Xu-chao Zhang, PhD
Qiang Nie, MD
Yi-long Wu, MD
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 4/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2754-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

KRAS Mutation in Patients with Lung Cancer: A Predictor for Poor Prognosis but Not for EGFR-TKIs or Chemotherapy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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