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Annals of Surgical Oncology

, Volume 20, Issue 4, pp 1381–1388 | Cite as

KRAS Mutation in Patients with Lung Cancer: A Predictor for Poor Prognosis but Not for EGFR-TKIs or Chemotherapy

  • Ji-lin Guan
  • Wen-zhao Zhong
  • She-juan An
  • Jin-ji Yang
  • Jian Su
  • Zhi-hong Chen
  • Hong-hong Yan
  • Zhi-yong Chen
  • Zhi-min Huang
  • Xu-chao Zhang
  • Qiang Nie
  • Yi-long WuEmail author
Thoracic Oncology

Abstract

Background

The prognostic and predictive value of KRAS mutations in patients with lung cancer is controversial. Biases in disease stage, treatment regimen, small-scale patient studies, and biomarker status have led to inconsistent results in previous reports.

Methods

The KRAS and EGFR genes were examined in 1935 consecutive patients with non-small cell lung cancer. All patients were divided into KRAS mutation (KRAS group), EGFR mutation (EGFR group), and KRAS/EGFR wild type (WT group) groups. Randomly selected cases were paired with patients with the KRAS mutation, the EGFR mutation, and KRAS/EGFR wild type patients according to tumor, node, metastasis stage, time of first visit within 1 year, and pathology. Progression-free survival (PFS) and overall survival were evaluated by Kaplan–Meier and Cox models.

Results

The KRAS mutation rate for lung adenocarcinoma was 5.90 %. The overall survival was 14.47, 20.57, and 42.73 months for the KRAS group, WT group, and EGFR group, respectively (P < 0.001). Multivariate analysis indicated that KRAS mutation status was an independent prognostic factor (hazard ratio 2.69, 95 % confidence interval 1.91–3.80, P < 0.001). No difference was found in PFS and tumor responsiveness between patients with a KRAS mutation and those with wild type KRAS/EGFR for chemotherapy and EGFR tyrosine kinase inhibitors (TKI). PFS did not significantly differ for chemotherapy among the three groups (P = 0.270).

Conclusions

KRAS mutation is a poor prognosis factor, but it is not an independent predictor of response to EGFR-TKI or chemotherapy in patients with lung cancer.

Keywords

Overall Survival Epidermal Growth Factor Receptor Epidermal Growth Factor Receptor Mutation KRAS Mutation Advanced NSCLC 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

Supported in part by grants from the National Natural Science Foundation of China (81001031, 30871126), Industry Technology Research and Development Project of Guangdong Science and Technology Department (2011A030400010), and Guangzhou Science and Information Technology Bureau (2011Y2-00014).

Disclosure

None of the authors have a potential conflict of interest

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Ji-lin Guan
    • 1
  • Wen-zhao Zhong
    • 1
  • She-juan An
    • 1
  • Jin-ji Yang
    • 1
  • Jian Su
    • 1
  • Zhi-hong Chen
    • 1
  • Hong-hong Yan
    • 1
  • Zhi-yong Chen
    • 1
  • Zhi-min Huang
    • 1
  • Xu-chao Zhang
    • 1
  • Qiang Nie
    • 1
  • Yi-long Wu
    • 1
    Email author
  1. 1.Guangdong Lung Cancer InstituteGuangdong General Hospital and Guangdong Academy of Medical SciencesGuangzhouChina

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