KRAS mutation in Non-Small Cell Lung Cancer

Authors

  • Pattama Wongsirisin

Keywords:

KRAS gene, non-small cell lung cancer, gene mutation, cancer drugs

Abstract

Lung cancer is the leading cause of cancer deaths worldwide. Especially, non-  small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. Oncogenic mutations in the Kirsten rat sarcoma viral oncogene (KRAS) gene play an important role in tumorigenesis and are mutated in approximately 30% of all NSCLC patients. KRAS functions by propagating signal transduction pathways upon   activation and is involved in cell differentiation and cell growth. Mutations of the  KRAS gene result in uncontrolled proliferation and development of cancer. NSCLCpatients with KRAS mutation respond poorly to chemotherapy and resistance to EGFR inhibitors. However, Immune checkpoint inhibitors show favourable outcomes for KRAS mutant patients, with an improved overall survival. Sotorasib (AMG510), the first drug-targeting KRAS (G12C) gene mutation has been approved in 2021 for KRAS mutated NSCLC (First-in-class), brings hope to the many patients who carry this mutation. In this article, role of oncogenic KRAS in prognosis and treatment of KRAS- mutant NSCLC are reviewed

References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

หน่วยงานทะเบียนมะเร็ง. ทะเบียนมะเร็งระดับโรงพยาบาล พ.ศ. 2563. กรุงเทพมหานคร: กลุ่มงานดิจิทัลการแพทย์ สถาบันมะเร็งแห่งชาติ; 2564

Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2016;11(1):39-51.

Chevallier M, Borgeaud M, Addeo A, Friedlaender A. Oncogenic driver mutations in non-small cell lung cancer: Past, present and future. World J Clin Oncol. 2021;12(4):217-37.

Harvey JJ. An Unidentified Virus Which Causes the Rapid Production of Tumours in Mice. Nature. 1964;204:1104-5.

Murdande SS. Role of rat sarcoma virus mutations in cancer and potential target for cancer therapy. Future Sci OA. 2020;6(4):FSO455.

Pylayeva-Gupta Y, Grabocka E, Bar-Sagi D. RAS oncogenes: weaving a tumorigenic web. Nat Rev Cancer. 2011;11(11):761-74.

Liu P, Wang Y, Li X. Targeting the untargetable KRAS in cancer therapy. Acta Pharm Sin B. 2019;9(5):871-9.

Pantsar T. The current understanding of KRAS protein structure and dynamics. Comput Struct Biotechnol J. 2020;18:189-98.

Wakuda K, Kenmotsu H, Serizawa M, Koh Y, Isaka M, Takahashi S, et al. Molecular profiling of small cell lung cancer in a Japanese cohort. Lung Cancer. 2014;84(2):139-44.

Cancer Genome Atlas Research N. Comprehensive molecular profiling of lung adenocarcinoma. Nature. 2014;511(7511):543-50.

การเปลี่ยนแปลงทางพันธุกรรม และการค้นหาตัวบ่งชี้ทางชีวภาพเชิงเมตาบอลอมิคส์ของโรคมะเร็งปอดในคนไทย (ปีที่ 3) [Internet]. [cited Jun 27, 2022]. Available from: https://kb.hsri.or.th/dspace/handle/11228/5256

Timar J. The clinical relevance of KRAS gene mutation in non-small-cell lung cancer. Curr Opin Oncol. 2014;26(2):138-44.

Veluswamy R, Mack PC, Houldsworth J, Elkhouly E, Hirsch FR. KRAS G12C-Mutant Non-Small Cell Lung Cancer: Biology, Developmental Therapeutics, and Molecular Testing. J Mol Diagn. 2021;23(5):507-20.

Woo T, Okudela K, Yazawa T, Wada N, Ogawa N, Ishiwa N, Tajiri M, Rino Y, Kitamura H and Masuda M. Prognostic value of KRAS mutations and Ki-67 expression in stage I lung adenocarcinomas. Lung Cancer. 2009; 65:355-62

Metro G, Chiari R, Bennati C, Cenci M, Ricciuti B, Puma F, Flacco A, Rebonato A, Giannarelli D, Ludovini V, Bellezza G, Ferolla P, Minotti V, et al. Clinical outcome with platinum-based chemotherapy in patients with advanced nonsquamous EGFR wild-type non-small-cell lung cancer segregated according to KRAS mutation status. Clin Lung Cancer. 2014; 15:86-92.

Marabese M, Ganzinelli M, Garassino MC, Shepherd FA, Piva S, Caiola E, et al. KRAS mutations affect prognosis of non-small-cell lung cancer patients treated with first-line platinum containing chemotherapy. Oncotarget. 2015;6(32):34014-22.

Lohinai Z, Klikovits T, Moldvay J, Ostoros G, Raso E, Timar J, et al. KRAS-mutation incidence and prognostic value are metastatic site-specific in lung adenocarcinoma: poor prognosis in patients with KRAS mutation and bone metastasis. Sci Rep. 2017;7:39721.

Goulding RE, Chenoweth M, Carter GC, Boye ME, Sheffield KM, John WJ, et al. KRAS mutation as a prognostic factor and predictive factor in advanced/metastatic non-small cell lung cancer: A systematic literature review and meta-analysis. Cancer Treat Res Commun. 2020;24:100200.

Mellema WW, Dingemans A-MC, Thunnissen E, Snijders PJF, Derks J, Heideman DAM, Van Suylen R and Smit EF. KRAS mutations in advanced nonsquamous non-small-cell lung cancer patients treated with first-line platinum-based chemotherapy have no predictive value. J Thorac Oncol. 2013; 8:1190-5.

Pan W, Yang Y, Zhu H, et al. KRAS mutation is a weak, but valid predictor for poor prognosis and treatment outcomes in NSCLC: A meta-analysis of 41 studies. Oncotarget. 2016

Wang Y, Chen J, Wu S, Hu C, Li X, Wang Y, et al. Clinical effectiveness and clinical toxicity associated with platinum-based doublets in the first-line setting for advanced non-squamous non-small cell lung cancer in Chinese patients: a retrospective cohort study. BMC Cancer. 2014;14:940.

Shi Y, Li J, Zhang S, Wang M, Yang S, Li N, et al. Molecular Epidemiology of EGFR Mutations in Asian Patients with Advanced Non-Small-Cell Lung Cancer of Adenocarcinoma Histology Mainland China Subset Analysis of the PIONEER study. PLoS One. 2015;10(11):e0143515.

Zhao Y, Wang H, He C. Drug resistance of targeted therapy for advanced non-small cell lung cancer harbored EGFR mutation: from mechanism analysis to clinical strategy. J Cancer Res Clin Oncol. 2021;147(12):3653-64

Torralvo J, Friedlaender A, Achard V, Addeo A. The Activity of Immune Checkpoint Inhibition in KRAS Mutated Non-small Cell Lung Cancer: A Single Centre Experience. Cancer Genomics Proteomics. 2019;16(6):577-82.

Mok TSK, Wu YL, Kudaba I, Kowalski DM, Cho BC, Turna HZ, et al. Pembrolizumab versus chemotherapy for previously untreated, PD-L1-expressing, locally advanced or metastatic non-small-cell lung cancer (KEYNOTE-042): a randomised, open-label, controlled, phase 3 trial. Lancet. 2019;393(10183):1819-30.

Dermani FK, Samadi P, Rahmani G, Kohlan AK, Najafi R. PD-1/PD-L1 immune checkpoint: Potential target for cancer therapy. J Cell Physiol. 2019;234(2):1313-25.

Majeed U, Manochakian R, Zhao Y, Lou Y. Targeted therapy in advanced non-small cell lung cancer: current advances and future trends. J Hematol Oncol. 2021;14(1):108.

Huang L, Guo Z, Wang F, Fu L. KRAS mutation: from undruggable to druggable in cancer. Signal Transduct Target Ther. 2021;6(1):386.

Jacobs F, Cani M, Malapelle U, Novello S, Napoli VM, Bironzo P. Targeting KRAS in NSCLC: Old Failures and New Options for "Non-G12c" Patients. Cancers (Basel). 2021;13(24).

Blair HA. Sotorasib: First Approval. Drugs. 2021;81(13):1573-9.

Skoulidis F, Li BT, Dy GK, Price TJ, Falchook GS, Wolf J, et al. Sotorasib for Lung Cancers with KRAS p.G12C Mutation. N Engl J Med. 2021;384(25):2371-81.

Nakajima EC, Drezner N, Li X, Mishra-Kalyani PS, Liu Y, Zhao H, et al. FDA Approval Summary: Sotorasib for KRAS G12C-Mutated Metastatic NSCLC. Clin Cancer Res. 2022;28(8):1482-6.

Fakih MG, Kopetz S, Kuboki Y, Kim TW, Munster PN, Krauss JC, et al. Sotorasib for previously treated colorectal cancers with KRAS(G12C) mutation (CodeBreaK100): a prespecified analysis of a single-arm, phase 2 trial. Lancet Oncol. 2022;23(1):115-24.

=LUMAKRAS® (SOTORASIB) CODEBREAK 100 STUDY SHOWS TWO-YEAR OVERALL SURVIVAL OF 32.5% IN PATIENTS WITH KRAS G12C-MUTATED ADVANCED NON-SMALL CELL LUNG CANCER [Internet]. [cited Jun 27, 2022]. Available from:https://www.amgen.com/newsroom/press-releases/2022/04/lumakras-sotorasib-codebreak-100-study-shows-twoyear-overall-survival-of-325-in-patients-with-kras-g12cmutated-advanced-nonsmall-cell-lung-cancer'

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Published

2022-12-31