Effects of Co-occurring Genomic Alterations on Outcomes in Patients with KRAS -Mutant Non-Small Cell Lung Cancer
mutations occur in approximately 25% of patients with non-small cell lung cancer (NSCLC). Despite the uniform presence of mutations, patients with -mutant NSCLC can have a heterogeneous clinical course. As the pattern of co-occurring mutations may describe different biological subsets of patients wi...
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Published in | Clinical cancer research Vol. 24; no. 2; pp. 334 - 340 |
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Main Authors | , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
American Association for Cancer Research Inc
15.01.2018
|
Subjects | |
Online Access | Get full text |
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Summary: | mutations occur in approximately 25% of patients with non-small cell lung cancer (NSCLC). Despite the uniform presence of
mutations, patients with
-mutant NSCLC can have a heterogeneous clinical course. As the pattern of co-occurring mutations may describe different biological subsets of patients with
-mutant lung adenocarcinoma, we explored the effects of co-occurring mutations on patient outcomes and response to therapy.
We identified patients with advanced
-mutant NSCLC and evaluated the most common co-occurring genomic alterations. Multivariate analyses were performed incorporating the most frequent co-mutations and clinical characteristics to evaluate association with overall survival as well as response to platinum-pemetrexed chemotherapy and immune checkpoint inhibitors.
Among 330 patients with advanced
-mutant lung cancers, the most frequent co-mutations were found in
(42%),
(29%), and
/
(27%). In a multivariate analysis, there was a significantly shorter survival in patients with co-mutations in
/
[HR, 1.96; 95% confidence interval (CI), 1.33-2.92;
≤ 0.001].
(HR, 1.3;
= 0.22) and
(HR 1.11,
= 0.58) co-mutation statuses were not associated with survival. Co-mutation in
/
was also associated with shorter duration of initial chemotherapy (HR, 1.64; 95% CI, 1.04-2.59;
= 0.03) and shorter overall survival from initiation of immune therapy (HR, 3.54; 95% CI, 1.55-8.11;
= 0.003).
Among people with
-mutant advanced NSCLC,
, and
/
are the most commonly co-occurring somatic genomic alterations. Co-mutation of
and
/
is an independent prognostic factor, predicting shorter survival, duration of response to initial platinum-based chemotherapy, and survival from the start of immune therapy.
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1078-0432 1557-3265 |
DOI: | 10.1158/1078-0432.CCR-17-1841 |