Retrospective Data Analysis of Patients With Metastatic Lung Adenocarcinoma With or Without KRAS-Mutation or TTF1-Expression

Abstract

Introduction Patients with lung adenocarcinoma not expressing TTF1 and those with a KRAS mutation have worse prognosis. However, available data are limited and sometimes contradictory. Therefore, this retrospective cohort analysis aimed to clarify whether there was a difference in overall survival and progression-free survival between these groups of patients. Methods In total, data derived from 181 patients with metastatic lung adenocarcinoma treated at the Martha-Maria Halle-Dölau Hospital from 2016 to 2019 were analyzed. Kaplan-Meier curves were generated, and associated values, such as median survival and its confidence intervals, were determined using the log-rank test. Results A benefit in overall survival (OS) (8.4 vs 5.8 months; HR, .8; 95% CI, .53-1.19; P = .267) was associated with positive TTF1 expression, but this was not statistically significant. The same trend was shown with the progressive free survival (PFS) (6.5 vs 4.6 months; HR, .76; 95% CI, .51-1.20; P = .162). In patients with a KRAS mutation, there was no difference in OS compared to those with a wildtype KRAS. The median survival was almost identical at 7.5 months ( KRAS mutation, 95% CI, 3.32-11.74) and 7.0 months ( KRAS wildtype, 95% CI, 3.59-10.41). Additionally, in PFS, there was no difference between the 2 groups (5.8 vs 6.3 months). Conclusions Our analysis did not show a worse prognosis in patients with a KRAS mutation or in those with missing TTF1 expression, which is most likely related to the new therapeutic options. As a result of the administration of immunotherapy in patients with a KRAS mutation and the change from a regimen containing pemetrexed to a regimen containing no pemetrexed, the corresponding patients no longer seem to have a worse prognosis.

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“…However, the same study also suggests that the administration of the use of immunotherapy in individuals harboring a KRAS mutation and the change from a regimen containing pemetrexed to a regimen containing no pemetrexed, the corresponding patients no longer seem to have a worse prognosis. [28][29][30] Que's published work in Frontiers in Oncology journal that describes an individual diagnosed with advanced lung adenocarcinoma exhibiting ALK positivity attained a pathological complete remission (pCR) in the primary lung lesion following various rounds of conversion therapy. utilizing immunotherapy following multiple lines of treatment in advanced lung adenocarcinoma with ALK positivity may provide a survival benefit.…”

“…However, the same study also suggests that the administration of the use of immunotherapy in individuals harboring a KRAS mutation and the change from a regimen containing pemetrexed to a regimen containing no pemetrexed, the corresponding patients no longer seem to have a worse prognosis. 28–30…”