1. Prognostic impact of KRAS mutation status for patients with stage IV adenocarcinoma of the lung treated with first-line pembrolizumab monotherapy
- Author
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Ronald A M Damhuis, A.L. Noordhof, Ben J.W. Venmans, A.J. de Langen, W. H. van Geffen, Wim Timens, Lizza E.L. Hendriks, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Groningen Research Institute for Asthma and COPD (GRIAC), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Pulmonologie, and MUMC+: MA Med Staf Spec Longziekten (9)
- Subjects
0301 basic medicine ,Oncology ,Mono-immunotherapy ,Cancer Research ,Lung Neoplasms ,Pembrolizumab ,medicine.disease_cause ,THERAPY ,B7-H1 Antigen ,0302 clinical medicine ,Non-small cell lung cancer ,Carcinoma, Non-Small-Cell Lung ,Lung ,Netherlands ,DOCETAXEL ,education.field_of_study ,Protein-Tyrosine Kinases ,Kirsten rat sarcoma ,Prognosis ,CANCER ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,SURVIVAL ,Adenocarcinoma ,KRAS ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Population ,Antibodies, Monoclonal, Humanized ,Proto-Oncogene Proteins p21(ras) ,03 medical and health sciences ,Internal medicine ,medicine ,Adenocarcinoma of the lung ,ROS1 ,Humans ,education ,Retrospective Studies ,business.industry ,medicine.disease ,PREDICTIVE-VALUE ,EFFICACY ,digestive system diseases ,Cancer registry ,030104 developmental biology ,Mutation ,business ,INHIBITORS - Abstract
OBJECTIVES: Monotherapy with pembrolizumab is the preferred first-line treatment for metastatic non-small cell lung cancer with programmed death-ligand 1 (PD-L1) expression ≥50 %, without targetable oncogenic drivers. Although targeted therapies are in development for patients with specific Kirsten rat sarcoma (KRAS) mutations, these are not available in daily care yet. It is not clear whether there is a difference in survival on first-line pembrolizumab for patients with a high PD-L1 status with or without a KRAS mutation. We aim to compare this survival based on real-world data.MATERIALS AND METHODS: This is a real-world retrospective population-based study using data from the Netherlands Cancer Registry. We selected patients with stage IV lung adenocarcinoma with PD-L1 expression ≥50 % diagnosed between January 2017 and December 2018, treated with first-line pembrolizumab. Patients with EGFR mutations, ALK translocations or ROS1 rearrangements were excluded. The primary outcome parameter was overall survival.RESULTS: 388 (57 %) of 595 patients had a KRAS mutation. KRAS was seen more frequently in women than in men (65 % versus 49 % respectively, p CONCLUSION: The survival of KRAS mutated versus KRAS wild-type lung adenocarcinoma patients, treated with first-line pembrolizumab monotherapy, is similar, suggesting that KRAS has no prognostic value with respect to treatment with pembrolizumab.
- Published
- 2021
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