Response to immunotherapy in KRAS G12C mutated NSCLC: a single-centre retrospective observational study
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Carolina Sciortino1, Valentina Viglialoro1, Massimo Nucci1, Mariam Grazia Polito1, Enrico Cortesi2, Alain Gelibter3, Paola Gazzaniga4, Chiara Nicolazzo4, Marco Siringo3 and Salvatore Caponnetto3
1 Department of Radiology, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
2 Medical Oncology Unit B, Department of Radiological Oncological and Pathological Sciences, University La Sapienza, Rome, Italy
3 Medical Oncology Unit B, Department of Radiology, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
4 Medical Oncology Unit, Department of Clinical and Molecular Medicine, Sapienza Università di Roma, Rome, Italy
Keywords: NSCLC; immunotherapy; KRAS G12C mutation; liquid biopsy
Received: March 11, 2022 Accepted: April 26, 2022 Published: May 11, 2022
Background: Non-small cell lung cancer is the leading cause of cancer death worldwide. New strategies in molecular therapies are being explored to detect and target genetic mutations in NSCLC. Therefore, it is also important to understand the interaction between these mutations and other therapies. This study focuses on possible correlations between the KRAS-G12C mutation and response of patients treated with immunotherapy.
Methods: Twenty-two patients with stage IV NSCLC undergoing immunotherapy were divided into two groups treated with first- and second-line therapy, respectively. KRAS-G12C mutation was detected by liquid biopsy Idylla KRAS assay.
Results: In first-line treated patients, there was no significant increase in PFS in patients with the KRAS mutation (20 months versus 14.5 months, HR = 1.31; CI 95% = 0.25–6.71; p value = 0.76) and no difference in OS (OS = 21 months, HR = 1; CI 95% = 0.17–6.2; p value > 0.99). In the second group, KRAS G12C mutated patients had a median PFS of 23 months compared with a median PFS of only 5 months among nonmutated patients (HR = 3.28; CI 95% = 0.86–12.5; p value = 0.03).
Conclusion: The results of this study do not reveal a clear correlation between mutation and response to immunotherapy. The mechanism regulating immune system activity in the tumor microenvironment remains unclear.
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