The following is a summary of “Prognostic value of KRAS G12C mutation in lung adenocarcinoma stratified by stages and radiological features,” published in the December 2023 issue of Surgery by Cao, et al.

Within the context of the potential clinical efficacy of KRAS G12C-specific inhibitors, the function of KRAS G12C is of special interest. For a study, researchers sought to explore the clinicopathological features and prognostic usefulness of the KRAS G12C mutation in patients who had undergone surgical resection of lung adenocarcinoma. 

Between 2008 and 2020, 3,828 individuals with primary lung adenocarcinomas that had been totally removed and who had undergone KRAS mutation analysis were included in the data collection process. It investigated whether or not there was a connection between KRAS G12C and clinicopathologic features, molecular profiles, recurrence patterns, and surgical outcomes. Seventy-two percent of the patients, or 275 individuals, were found to have a KRAS mutation, and 32% of those patients had the G12C subtype. 

There was a higher incidence of KRAS G12C in males, those who had smoked in the past or who were smoking now, radiologic solid nodules, invasive mucinous adenocarcinoma, and solid predominant tumors. Compared to KRAS wild-type cancers, KRAS G12C tumors exhibited a greater degree of lymphovascular invasion and a higher level of expression of programmed death-ligand 1. Within the KRAS G12C group, the three mutations that were experienced the most often were TP53 (36.8%), STK11 (26.3%), and RET (18.4%). Patients with the KRAS G12C mutation were more likely to develop early recurrence as well as locoregional recurrence, according to information obtained from logistic regression analysis. 

Using propensity score matching, it was discovered that the KRAS G12C mutation was substantially related to poor survival. The KRAS G12C was shown to be an independent prognostic factor in stage I tumors and part-solid lesions, respectively, according to the results of a stratified study. In both stage I lung adenocarcinomas and part-solid tumors, the KRAS G12C mutation was shown to have a considerable impact on the prognostic value of the disease. Additionally, it had a phenotype related to early and locoregional recurrence, which was associated with a potentially aggressive nature. Because improved KRAS therapies are now being researched for clinical use, these results may be significant.

Source: sciencedirect.com/science/article/abs/pii/S0022522323003616