Characterization of Patients with KRAS-Mutated Advanced Non-Small Cell Lung Cancer

Introduction: KRAS comprise the most frequently found oncogene driver mutation in non-small cell lung cancer (NSCLC), accounting for 20-25% of these patients. KRAS mutant NSCLC has been associated with poorer survival, and no targeted therapy is currently approved. This study aimed to characterize the KRAS mutant NSCLC. Methods: A retrospective analysis of NSCLC patients, who performed next generation sequence (NGS) was carried out. KRAS mutant NSCLC demographic and clinical characteristics were reviewed. Results: Of 127 patients included, 27.6% had KRAS mutation (mean age 65.8±8.5 years). Patients with KRAS mutation were more likely to be males (80%, p=0.014) and smokers (88.6%, p=0.001). Thirty KRAS mutations were located in codon 12 (Gly12Cys, n=12; Gly12Val, n=9; Gly12Asp, n=7; Gly12Ala, n=2), 2 in codon 13 (Gly13Asp and Gly13Cys), 2 in codon 61 (Gln61His and Gln61Arg) and 1 in codon 60 (Gly60Asp). The most frequent metastatic sites were lung (42.9%) and bone (40%). KRAS-mutated group metastasize less to pleura compared with non-mutated group (11.4% vs 31.9%, p=0.030). Although mostly stage IV at the diagnosis (82.8%), KRAS-mutated group presented a better performance status (PS) compared to non-mutated group (PS 0-1 94.3% vs. 63.8%, p=0.001). Mean progression-free survival (PFS) in KRAS-mutated group tended to be shorter than in non-mutated group (3.6 vs. 4.2 months, p=0.658), as was the overall survival (OS) (7.1 vs 7.6 months, p=0.726). Conclusion: KRAS mutant NSCLC are more frequent in smoking male patients. Although KRAS-mutated group had a better PS at diagnosis, had a lower OS/PFS when compared with KRAS non-mutated group, which suggest that these patients present an aggressive disease.