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Lung Cancer: Treatment of advanced non-small cell lung cancer with KRAS G12C mutation: a real cohort study from Germany's prospective, observational, and national CRISP registry (AIO-TRK-0315)

 Last Update: 2021-08-02
 Source: Internet
 Author: User

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The KRAS gene is one of the most common oncogenic driver mutations
.

KRAS gene mutations occur in 20%-40% of NSCLC patients in the Western population

The KRAS gene is one of the most common oncogenic driver mutations

The study included 1039 patients with KRAS mutation or wild-type NSCLC, and they were divided into three groups: KRAS wild-type, KRAS G12C and KRAS non-G12C mutation
.

There were 628 cases (60.

The study included 1039 patients with KRAS mutation or wild-type NSCLC, and they were divided into three groups: KRAS wild-type, KRAS G12C and KRAS non-G12C mutation

Research Overview

Research overviewResearch overview

Among the 411 patients with KRAS mutations, G12C was 38.
9%, G12V was 21.
2%, G12A was 9.
5%, G12D was 13.
9%, and G12S was 1.
0%
.

The proportions of KRAS wild-type, KRAS G12C and KRAS non-G12C mutation groups with PD-L1 levels >50% were 28.

Among the 411 patients with KRAS mutations, G12C was 38.

KRAS mutation subtype and PDL1 expression level

In the first-line treatment, the proportion of KRAS wild-type, KRAS G12C and KRAS non-G12C mutant groups receiving checkpoint inhibitors (CPI) was 36.
0% (wildtype), 50.
1% (G12C), and 41.
8% (non-G12C), respectively ; The proportions of single-agent therapy were 21.
2%, 31.
3% and 21.
1%), or the proportions of combined chemotherapy were 14.
8%, 18.
8% and 20.
7%, respectively
.

The proportions of receiving platinum combination therapy were 47.

In the first-line treatment, the proportion of KRAS wild-type, KRAS G12C and KRAS non-G12C mutant groups receiving checkpoint inhibitors (CPI) was 36.

First-line treatment situation

There was no significant difference in clinical prognosis among the three groups of KRAS wild type, KRAS G12C and KRAS non-G12C mutations
.

The median PFS of KRAS wild-type non-squamous cell carcinoma patients was 5.

There was no significant difference in clinical prognosis among the three groups of KRAS wild type, KRAS G12C and KRAS non-G12C mutations

PFS and OS

The median OS of KRAS wild-type non-squamous cell carcinoma patients was 11.
6 months (95% CI 9.
5–13.
4); the median OS of KRAS wild-type squamous cell carcinoma patients was 15.
8 months (95% CI 10.
5–20.
4); KRAS G12C mutation The median PFS of the patients was 11.
6 months (95% CI 9.
0–18.
1); the KRAS non-G12C mutation patients were 10.
4 months (95% CI 8.
4–14.
0)
.

Multivariate analysis of prognostic indicators, poor ECOG score (ECOG ≥2 vs.
ECOG =0) is associated with increased risk of death (HR 1.
97, 95% CI 1.
31–2.
97, p = 0.
001); KRAS mutation status has no significant prognosis Related
.
Compared with PD-L1 TPS<1%, PD-L1 TPS ≥50% of patients (HR 0.
39, 95% CI 0.
26−0.
60, p = <0.
001) and 1%≤ PD-L1 TPS <50% (HR 0.
61, 95% CI 0.
41−0.
90, p = 0.
012) The patient's risk of death was significantly reduced
.
Compared with PD-L1 TPS<1%, PD-L1 TPS ≥50% of patients (HR 0.
39, 95% CI 0.
26−0.
60, p = <0.
001) and 1%≤ PD-L1 TPS <50% (HR 0.
61, 95% CI 0.
41−0.
90, p = 0.
012) The patient's risk of death was significantly reduced
.

Prognostic factors

In summary, this study is currently a larger prospective observation cohort describing the treatment status of KRAS G12C mutant NSCLC.
It can be seen that the prognosis of patients with KRAS G12C mutant NSCLC is poor, and it also provides ideas for future treatment
.
This study is currently a larger prospective observation cohort describing the treatment status of KRAS G12C mutant NSCLC.
It can be seen that the prognosis of KRAS G12C mutant NSCLC patients is poor, and it also provides ideas for future treatment
.
This study is currently a larger prospective observation cohort describing the treatment status of KRAS G12C mutant NSCLC.
It can be seen that the prognosis of KRAS G12C mutant NSCLC patients is poor, and it also provides ideas for future treatment
.

Original source:

Sebastian M, Eberhardt WEE, Hoffknecht P, et al.
KRAS G12C-mutated advanced non-small cell lung cancer: A real-world cohort from the German prospective, observational, nation-wide CRISP Registry (AIO-TRK-0315).
Lung Cancer.
2021 Apr;154:51-61.
doi: 10.
1016/j.
lungcan.
2021.
02.
005.
PMID: 33611226.

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