In a study that analyzed outcomes among Asian patients with NSCLC who received different chemotherapeutic regimens, significantly worse rates of PFS and OS were seen in patients with KRAS mutations treated with the antimetabolites pemetrexed or gemcitabine than in the KRAS wild-type group. However, there was no difference in treatment outcomes according to KRAS mutation status among patients who received taxane therapy. In addition, a pooled analysis revealed that patients with KRAS codon 13 mutations derived significant harm from receiving adjuvant chemotherapy. These studies and others like them suggest that type of chemotherapy and the exact type of KRAS mutation may be important considerations when selecting treatment for KRAS-mutated NSCLC.
Most studies, including a meta-analysis of 22 studies, suggest that KRAS mutational status is a significant negative predictor of EGFR-TKI therapy efficacy. However, controversy and discrepancies in study results exist. Some investigators have theorized that the response to EGFR-TKI therapy is strongly influenced by the involved KRAS codons and the type of amino acid substitutions in a patient's particular cancer.
Learn more about the treatment of patients with NSCLC.
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Cite this: Winston W. Tan, Maurie Markman. Fast Five Quiz: KRAS Mutations in Non-Small Cell Lung Cancer - Medscape - Aug 16, 2022.