Prognostic impact of KRAS mutation status for patients with stage IV adenocarcinoma of the lung treated with first-line pembrolizumab monotherapy

被引:30
|
作者
Noordhof, A. L. [1 ]
Damhuis, R. A. M. [2 ]
Hendriks, L. E. L. [3 ]
de Langen, A. J. [4 ]
Timens, W. [5 ]
Venmans, B. J. W. [1 ]
van Geffen, W. H. [1 ]
机构
[1] Med Ctr Leeuwarden, Dept Resp Med, Henri Dunantweg 2, NL-8934 AD Leeuwarden, Netherlands
[2] Comprehens Canc Org, Dept Res, Plesmanlaan 121, NL-1066 CX Utrecht, Netherlands
[3] Maastricht Univ, GROW Sch Oncol & Dev Biol, Dept Resp Med, Med Ctr, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands
[4] Netherlands Canc Inst, Dept Thorac Oncol, NL-1007 MB Amsterdam, Netherlands
[5] Univ Groningen, Univ Med Ctr Groningen, Dept Pathol & Med Biol, Hanzepl 1, NL-9713 GZ Groningen, Netherlands
关键词
Non-small cell lung cancer; Kirsten rat sarcoma; Mono-immunotherapy; PREDICTIVE-VALUE; CANCER; EFFICACY; INHIBITORS; DOCETAXEL; SURVIVAL; THERAPY;
D O I
10.1016/j.lungcan.2021.04.001
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 < 0.001). The median overall survival was 19.2 months versus 16.8 months for patients with and without KRAS mutation, respectively (p = 0.86). Multivariable analysis revealed WHO performance score, number of organs with metastases and PD-L1 percentage as independent prognostic factors. KRAS mutation status had no prognostic influence (hazard ratio = 1.03, 95 % CI 0.83-1.29). 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.
引用
收藏
页码:163 / 169
页数:7
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