The Korean journal of internal medicine

  • 제32권3호
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  • Pages.514-522
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  • 2017
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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KRAS G12C mutation as a poor prognostic marker of pemetrexed treatment in non-small cell lung cancer

  • Park, Sehhoon (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Ji-Yeon (Department of Internal Medicine, Seoul National University Hospital) ;
  • Lee, Se-Hoon (Department of Internal Medicine, Seoul National University Hospital) ;
  • Suh, Beomseok (Department of Family Medicine and Health Promotion Center, Seoul National University Hospital) ;
  • Keam, Bhumsuk (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Tae Min (Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Dong-Wan (Department of Internal Medicine, Seoul National University Hospital) ;
  • Heo, Dae Seog (Department of Internal Medicine, Seoul National University Hospital)
  • 투고 : 2015.09.01
  • 심사 : 2015.10.19
  • 발행 : 2017.05.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: The predictive and prognostic value of KRAS mutation and its type of mutations in non-small cell lung cancer (NSCLC) are controversial. This clinical study was designed to investigate the predictive value of KRAS mutations and its mutation types to pemetrexed and gemcitabine based treatment. Methods: Advanced NSCLC patients tested for KRAS mutation (n = 334) were retrospectively reviewed and 252 patients with wild type epidermal growth factor receptor and no anaplastic lymphoma kinase fusion were enrolled for the analysis. KRAS mutations were observed in 45 subjects with mutation type as followed: G12C (n = 13), G12D (n = 12), G12V (n = 12), other (n = 8). Response rate (RR), progression-free survival (PFS), and overall survival (OS) of pemetrexed singlet and gemcitabine based chemotherapy were analysis. Results: Age, sex, performance status were well balanced between subjects with or without KRAS mutations. No difference was observed in RR. Hazard ratio (HR) of PFS for pemetrexed treated subjects with G12C mutation compared to subjects with KRAS wild type was 1.96 (95% confidential interval [CI], 1.01 to 3.79; p = 0.045), but other mutations failed to show clinical significance. By analysis done by PFS, compared to the subjects with transition mutation, HR was 1.48 (95% CI, 0.64 to 3.40; p = 0.360) for subjects with transversion mutation on pemetrexed treatment and 0.41 (95% CI, 0.19 to 0.87; p = 0.020) for subjects treated with gemcitabine based chemotherapy. No difference was observed in OS. Conclusions: In this study, different drug sensitivity was observed according to the type of KRAS mutation. NSCLC subpopulations with different KRAS mutation type should be considered as different subgroups and optimal chemotherapy regimens should be searched in further confirmative studies.

키워드

과제정보

연구 과제 주관 기관 : Innovative Research Institute

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