The prognosis and adjuvant chemotherapy in KRAS mutation patients with stage I lung adenocarcinoma

• Published in: Clinical Surgical Oncology 2024-12, Vol.3 (4), p.100069, Article 100069
• Main Authors: Ma, Shangshang, Li, Kun, Wang, Rangrang, Qian, Jiayi, Fan, Yongfei, Qin, Xichun, Li, Mingjun, Wu, Leilei
• Format: Article
• Language: English
• Subjects: adjuvant chemotherapy; Co-mutation; KRAS mutation; lung adenocarcinoma; Prognosis
• ISSN: 2773-160X; 2773-160X
• DOI: 10.1016/j.cson.2024.100069

Adjuvant chemotherapy (ACT) remains the current first-line systemic treatment option for patients with KRAS-mutated lung adenocarcinoma (LUAD), but the response is not effective. The prognosis of ACT in patients with KRAS mutations in stage I LUAD has not yet been effectively explored. Detailed data about patients with stage I LUAD from Shanghai Pulmonary Hospital were collected in this ambispective study. Pearson's Chi-square test, Kaplan-Meier analysis, and Cox proportional hazard models were performed in this study. The primary observational endpoint was overall survival (OS). Sensitivity analysis was performed to assess the robustness of the findings. In this study population, 10.87% (194 out of 1783) of stage I LUAD patients possessed KRAS mutations. In the KRAS-mutated cohort, 7 patients harbored EGFR L858R point mutation, 2 patients exhibited EGFR exon 19 Del mutation, 2 patients had ALK rearrangement, and 1 patient for other EGFR mutations. Patients harboring KRAS mutations had a worse OS compared to KRAS wild-type (WT) patients (5-year OS rate: 96% vs. 82%, P ​