Clinical and Translational Oncology

, Volume 20, Issue 5, pp 591–598 | Cite as

Urinary cell-free DNA as a prognostic marker for KRAS-positive advanced-stage NSCLC

  • F. Xie
  • P. Li
  • J. Gong
  • H. Tan
  • J. MaEmail author
Research Article



KRAS mutations are prevalent in non-small cell lung cancer (NSCLC) but its clinical implications remain to be determined. Continual profiling of KRAS mutations in patients is challenging, and the study aims to determine the potential use of urinary DNA in disease predictions.


A total of 150 patients were recruited. To ascertain the clinical relevance of urinary DNA, matched tumor profiles were analyzed. Serial measurements were taken to gauge the reliability of the assay. These results were correlated to overall survival using the Kaplan–Meier estimate.


A good overall concordance of 93% (consolidated results from serial measurements) was achieved between tumor tissue and urinary DNA profiling. Of the discordant KRAS cases, we observed subsequent positive detection during monitoring and very low concentrations of mutant DNA. In addition, we noted that KRAS-positive patients detected using urinary DNA have good prognostic utility. Interestingly, we also observed that the trend is highly correlative of the rate of change in KRAS mutant DNA concentrations and the period of monitoring.


Urinary DNA offered a non-invasive approach to probe NSCLC dynamics, and in our study we showed that it had predictive capabilities for KRAS-positive patients. Serial monitoring of urinary samples showed that it had a predictive role in identifying patients with worse outcome.


Non-small cell lung cancer KRAS Disease prognosis Non-invasive liquid biopsy 



This work was funded by a research grant provided by the Yangtze University.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Patients were recruited after providing informed consent to participate in the trial. The recruitment process and sample extractions followed strictly the guidelines approved by the institutional review board (IRB).


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2017

Authors and Affiliations

  1. 1.Department of Respiratory Medicine, The Second Clinical Medical CollegeYangtze UniversityJingzhouPeople’s Republic of China
  2. 2.Department of Medical Oncology, Tongji Medical CollegeHuazhong University of Science and Technology (HUST)WuhanPeople’s Republic of China

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