Clinical Research Papers:
KRAS mutations affect prognosis of non-small-cell lung cancer patients treated with first-line platinum containing chemotherapy
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Mirko Marabese1,*, Monica Ganzinelli2,*, Marina C. Garassino2, Frances A. Shepherd3, Sheila Piva4, Elisa Caiola1, Marianna Macerelli2, Anna Bettini5, Calogero Lauricella6, Irene Floriani1, Gabriella Farina4, Flavia Longo7, Lucia Bonomi5, M. Agnese Fabbri8, Silvio Veronese6, Silvia Marsoni9, Massimo Broggini1 and Eliana Rulli1
1 Oncology Department, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
2 Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
3 Princess Margaret Cancer Center, University of Toronto, Toronto, Canada
4 Oncology Department, Ospedale Fatebenefratelli e Oftalmico, Milan, Italy
5 Oncology Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
6 Molecular Pathology Unit, Niguarda Cancer Center, Ospedale Niguarda Ca’ Granda, Milan, Italy
7 Medical Oncology, Policlinico Umberto I, Rome, Italy
8 Ospedale Belcolle, Viterbo, Italy
9 Clinical Trials Coordination Unit, Institute for Cancer Research and Treatment, IRCCS, Candiolo, Italy
* These authors equally contributed to this work
Massimo Broggini, email:
Marina C. Garassino, email:
Keywords: KRAS, NSCLC, platinum, first-line
Received: May 04, 2015 Accepted: August 26, 2015 Published: September 15, 2015
KRAS mutations seem to indicate a poor outcome in Non-Small-Cell Lung Cancer (NSCLC) but such evidence is still debated. The aim of this planned ancillary study within the TAILOR trial was to assess the prognostic value of KRAS mutations in advanced NSCLC patients treated with platinum-based first-line chemotherapy. Patients (N = 540), enrolled in the study in 52 Italian hospitals, were centrally genotyped twice in two independent laboratories for EGFR and KRAS mutational status.
Of these, 247 patients were eligible and included in the present study. The primary endpoint was overall survival (OS) according to KRAS mutational status in patients harboring EGFR wild-type.
Sixty (24.3%) out of 247 patients harbored KRAS mutations. Median OS was 14.3 months and 10.6 months in wild-type and mutated KRAS patients, respectively (unadjusted Hazard Ratio [HR]=1.41, 95%Confidence Interval [CI]: 1.03-1.94 P = 0.032; adjusted HR=1.39, 95%CI: 1.00-1.94 P = 0.050). This study, with all consecutive patients genotyped, indicates that the presence of KRAS mutations has a mild negative impact on OS in advanced NSCLC patient treated with a first-line platinum-containing regimen. Trial Registration:clinicaltrials.gov identifierNCT00637910
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