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Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors
SIMPLE SUMMARY: The molecular and clinical features of KRAS-mutated lung cancer patients treated with immunotherapy have yet to be well characterized, and little information is known about resistance in these patients. The goal of this study is to better understand the survival results of KRAS-mutat...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562655/ https://www.ncbi.nlm.nih.gov/pubmed/36230855 http://dx.doi.org/10.3390/cancers14194933 |
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author | Zhao, Dan Li, Haiqing Mambetsariev, Isa Mirzapoiazova, Tamara Chen, Chen Fricke, Jeremy Kulkarni, Prakash Villaflor, Victoria Arvanitis, Leonidas Hamilton, Stanley Afkhami, Michelle Pillai, Raju Armstrong, Brian Erhunmwunsee, Loretta Massarelli, Erminia Sattler, Martin Amini, Arya Salgia, Ravi |
author_facet | Zhao, Dan Li, Haiqing Mambetsariev, Isa Mirzapoiazova, Tamara Chen, Chen Fricke, Jeremy Kulkarni, Prakash Villaflor, Victoria Arvanitis, Leonidas Hamilton, Stanley Afkhami, Michelle Pillai, Raju Armstrong, Brian Erhunmwunsee, Loretta Massarelli, Erminia Sattler, Martin Amini, Arya Salgia, Ravi |
author_sort | Zhao, Dan |
collection | PubMed |
description | SIMPLE SUMMARY: The molecular and clinical features of KRAS-mutated lung cancer patients treated with immunotherapy have yet to be well characterized, and little information is known about resistance in these patients. The goal of this study is to better understand the survival results of KRAS-mutated patients who undergo immunotherapy treatment. For this effort, we have included 87 patients with NSCLC who received immunotherapy at the City of Hope, and we found that, among 87 patients, 32 had a KRAS G12C mutation (36.8%), 19 had G12V (21.9%), 18 had G12D (20.7%), 6 had G12A (6.9%), 3 had G12R (3.45%), and 10 had amplification (11.49%) and other uncommon mutations. G12D patients were found to respond differently compared to other KRAS-mutated patients. The OS with other KRAS comutations was not statistically significant, including STK11 and KEAP1. KRAS mutation subtypes such as G12D and comutations such as CDKN2/A and MET may modulate the immunotherapy responses and outcome in lung cancer. ABSTRACT: Background: The molecular and clinical features of KRAS-mutated lung cancer patients treated with immunotherapy have yet to be characterized, which could guide the development of therapeutics targeting KRAS with potential immuno-oncology treatment combinations. Research Question: Do KRAS-mutated patients with different subtypes and comutations have different clinical responses and overall survival (OS) to checkpoint inhibitors? Study Design and Methods: 87 patients with NSCLC at the City of Hope who received immune checkpoint inhibitors were identified and analyzed retrospectively. Tumor genomic alterations were extracted from the clinical data with next-generation sequencing using various platforms. Demographic, clinical, molecular, and pathological information was collected with the approval of the institutional review board of the City of Hope. OS was calculated if it was available at the study time point, and responses were determined according to the RECIST v1.1. Results: Among 87 patients, 32 had a KRAS G12C mutation (36.8%), 19 had G12V (21.9%), 18 had G12D (20.7%), 6 had G12A (6.9%), 3 had G12R (3.45%), and 10 had amplification (11.49%) and other uncommon mutations. G12D had a statistically significant Odds Ratio (OR) between patients who had responses and progression of the disease (OR (95% CI) = 0.31 (0.09–0.95), p < 0.05), with 5 G12D-mutated patients having responses and 11 G12D-mutated patients having progression of the disease. In the univariate analysis with OS, there was a trend of better OS in the G12D-mutated patients, with no statistically significant difference in terms of OS between the patients who had G12D mutation and the patients who had other KRAS mutations (HR (95% CI) = 0.53 (0.21–1.36), p = 0.185). The median OS was significantly worse with KRAS comutation CDKN2A/B loss (4.2 vs. 16.9 months, HR = 3.07 (1.09–8.69), p < 0.05) and MET (3.4 vs. 17 months, HR = 3.80 (1.44–10.05), p < 0.01), which were included for the multivariate analysis. The OS with other KRAS comutations was not statistically significant, including STK11 and KEAP1. Conclusion: KRAS mutation subtypes such as G12D and comutations such as CDKN2/A and MET may modulate the immunotherapy responses and outcomes in lung cancer. |
format | Online Article Text |
id | pubmed-9562655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-95626552022-10-15 Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors Zhao, Dan Li, Haiqing Mambetsariev, Isa Mirzapoiazova, Tamara Chen, Chen Fricke, Jeremy Kulkarni, Prakash Villaflor, Victoria Arvanitis, Leonidas Hamilton, Stanley Afkhami, Michelle Pillai, Raju Armstrong, Brian Erhunmwunsee, Loretta Massarelli, Erminia Sattler, Martin Amini, Arya Salgia, Ravi Cancers (Basel) Article SIMPLE SUMMARY: The molecular and clinical features of KRAS-mutated lung cancer patients treated with immunotherapy have yet to be well characterized, and little information is known about resistance in these patients. The goal of this study is to better understand the survival results of KRAS-mutated patients who undergo immunotherapy treatment. For this effort, we have included 87 patients with NSCLC who received immunotherapy at the City of Hope, and we found that, among 87 patients, 32 had a KRAS G12C mutation (36.8%), 19 had G12V (21.9%), 18 had G12D (20.7%), 6 had G12A (6.9%), 3 had G12R (3.45%), and 10 had amplification (11.49%) and other uncommon mutations. G12D patients were found to respond differently compared to other KRAS-mutated patients. The OS with other KRAS comutations was not statistically significant, including STK11 and KEAP1. KRAS mutation subtypes such as G12D and comutations such as CDKN2/A and MET may modulate the immunotherapy responses and outcome in lung cancer. ABSTRACT: Background: The molecular and clinical features of KRAS-mutated lung cancer patients treated with immunotherapy have yet to be characterized, which could guide the development of therapeutics targeting KRAS with potential immuno-oncology treatment combinations. Research Question: Do KRAS-mutated patients with different subtypes and comutations have different clinical responses and overall survival (OS) to checkpoint inhibitors? Study Design and Methods: 87 patients with NSCLC at the City of Hope who received immune checkpoint inhibitors were identified and analyzed retrospectively. Tumor genomic alterations were extracted from the clinical data with next-generation sequencing using various platforms. Demographic, clinical, molecular, and pathological information was collected with the approval of the institutional review board of the City of Hope. OS was calculated if it was available at the study time point, and responses were determined according to the RECIST v1.1. Results: Among 87 patients, 32 had a KRAS G12C mutation (36.8%), 19 had G12V (21.9%), 18 had G12D (20.7%), 6 had G12A (6.9%), 3 had G12R (3.45%), and 10 had amplification (11.49%) and other uncommon mutations. G12D had a statistically significant Odds Ratio (OR) between patients who had responses and progression of the disease (OR (95% CI) = 0.31 (0.09–0.95), p < 0.05), with 5 G12D-mutated patients having responses and 11 G12D-mutated patients having progression of the disease. In the univariate analysis with OS, there was a trend of better OS in the G12D-mutated patients, with no statistically significant difference in terms of OS between the patients who had G12D mutation and the patients who had other KRAS mutations (HR (95% CI) = 0.53 (0.21–1.36), p = 0.185). The median OS was significantly worse with KRAS comutation CDKN2A/B loss (4.2 vs. 16.9 months, HR = 3.07 (1.09–8.69), p < 0.05) and MET (3.4 vs. 17 months, HR = 3.80 (1.44–10.05), p < 0.01), which were included for the multivariate analysis. The OS with other KRAS comutations was not statistically significant, including STK11 and KEAP1. Conclusion: KRAS mutation subtypes such as G12D and comutations such as CDKN2/A and MET may modulate the immunotherapy responses and outcomes in lung cancer. MDPI 2022-10-08 /pmc/articles/PMC9562655/ /pubmed/36230855 http://dx.doi.org/10.3390/cancers14194933 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Zhao, Dan Li, Haiqing Mambetsariev, Isa Mirzapoiazova, Tamara Chen, Chen Fricke, Jeremy Kulkarni, Prakash Villaflor, Victoria Arvanitis, Leonidas Hamilton, Stanley Afkhami, Michelle Pillai, Raju Armstrong, Brian Erhunmwunsee, Loretta Massarelli, Erminia Sattler, Martin Amini, Arya Salgia, Ravi Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors |
title | Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors |
title_full | Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors |
title_fullStr | Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors |
title_full_unstemmed | Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors |
title_short | Clinical and Molecular Features of KRAS-Mutated Lung Cancer Patients Treated with Immune Checkpoint Inhibitors |
title_sort | clinical and molecular features of kras-mutated lung cancer patients treated with immune checkpoint inhibitors |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9562655/ https://www.ncbi.nlm.nih.gov/pubmed/36230855 http://dx.doi.org/10.3390/cancers14194933 |
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