Your browser doesn't support javascript.
loading
Plunging Into the PACIFIC: Outcomes of Patients With Unresectable KRAS-Mutated Non-Small Cell Lung Cancer Following Definitive Chemoradiation and Durvalumab Consolidation.
Barsouk, Adam; Friedes, Cole; Iocolano, Michelle; Doucette, Abigail; Cohen, Roger B; Robinson, Kyle W; D'Avella, Christopher A; Marmarelis, Melina E; Kosteva, John A; Singh, Aditi P; Ciunci, Christine A; Levin, William P; Cengel, Keith A; Bradley, Jeffrey D; Feigenberg, Steven J; Sun, Lova; Aggarwal, Charu; Langer, Corey J; Yegya-Raman, Nikhil.
Afiliación
  • Barsouk A; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: Adam.barsouk@pennmedicine.upenn.edu.
  • Friedes C; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Iocolano M; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Doucette A; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Cohen RB; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Robinson KW; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • D'Avella CA; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Marmarelis ME; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Kosteva JA; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Singh AP; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Ciunci CA; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Levin WP; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Cengel KA; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Bradley JD; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Feigenberg SJ; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Sun L; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Aggarwal C; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Langer CJ; Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Yegya-Raman N; Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: Nikhil.Yegya-Raman@pennmedicine.upenn.edu.
Clin Lung Cancer ; 25(3): e161-e171, 2024 May.
Article en En | MEDLINE | ID: mdl-38195320
ABSTRACT

BACKGROUND:

Immune checkpoint inhibitor (ICI) consolidation following concurrent chemoradiotherapy (CRT) substantially improved progression free survival (PFS) and overall survival (OS) in the PACIFIC trial becoming the standard of care in locally-advanced, unresectable NSCLC. KRAS mutation may influence response to ICI.

METHODS:

In this single-institution, retrospective analysis, we compared treatment outcomes for patients with unresectable KRAS mutated (KRAS-mt) and wild-type (KRAS-wt) NSCLC treated with CRT between October 2017 and December 2021. Kaplan-Meier analysis was conducted comparing median progression free survival and median overall survival from completion of radiotherapy in all KRAS-mt patients and KRAS-G12C-mutated patients. Outcomes were also compared with and without ICI consolidation.

RESULTS:

Of 156 patients, 42 (26.9%) were KRAS-mt and 114 (73.1%) were KRAS-wt. Baseline characteristics differed only in histology; KRAS-mt NSCLC more likely to be adenocarcinoma. KRAS-mt patients had worse PFS (median 6.3 vs. 10.7 months, P = .041) but similar OS (median 23.1 vs. 27.3 months, P = .237). KRAS-mt patients were more likely to not receive ICI due to rapid disease progression post-CRT (23.8% vs. 4.4%, P = .007). Among patients who received ICI (n = 114), KRAS-mt was not associated with inferior PFS (8.1 vs. 11.9 months, P = .355) or OS (30.5 vs. 31.7 months, P = .692). KRAS-G12C patients (n = 22) had similar PFS and OS to other KRAS-mt.

CONCLUSION:

In one of the largest post-CRT KRAS-mt cohort published, KRAS-mt was associated with inferior PFS, largely due to rapid progression prior to ICI consolidation, but did not affect OS. Among those who received ICI consolidation, outcomes were comparable regardless of KRAS-mt status.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Proteínas Proto-Oncogénicas p21(ras) / Carcinoma de Pulmón de Células no Pequeñas / Quimioradioterapia / Neoplasias Pulmonares / Mutación Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Proteínas Proto-Oncogénicas p21(ras) / Carcinoma de Pulmón de Células no Pequeñas / Quimioradioterapia / Neoplasias Pulmonares / Mutación Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos