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Tumor Mutational Status May Predict Recurrence, Survival Patterns for Patients With Early-Stage Non-Small Cell Lung Cancer
Results from a retrospective analysis study found that tumor mutational status can potentially predict recurrence and survival patterns for patients with surgically resected, stage I non-small cell lung cancer (NSCLC).
According to Daniel Libby, MD, Weill Cornell Medicine, New York, New York, and coauthors, surgical resection “has a favorable prognosis with an expected recurrence rate of about 30% [however] new methods to risk stratify patients with stage I NSCLC are needed to help select those that might benefit from more active surveillance or adjuvant therapy.”
In this study, researchers collected tumor samples from 570 patients with surgically resected stage I NSCLC. Samples were analyzed using next-generation sequencing and tumor mutational frequencies were matched with clinical data. Primary end points included patterns of disease survival and recurrence. Key secondary end points included survival patterns by mutational status and identification of comorbidities associated with survival and recurrence.
At analysis, 12.5% of patients developed disease recurrence. Recurrence occurred in 37.5% of patients with a KRAS G12V mutation and 11.1% of patients without a KRAS G12V mutation (P < .001). Recurrence occurred in 6.74% of patients with an EGFR mutation and 14.9% of patients without an EGFR mutation (P = .006). Univariate analysis results demonstrated that decreased survival was predicted by the presence of a KRAS 612V (P = .006) and other TP53 mutations (P = .025). Multivariable results demonstrated that KRAS 612V, KRAS G13D, MET E168D, PTEN, and other TP53 mutations were associated with reduced survival.
Comorbidities associated with reduced survival included coronary artery disease, type 2 diabetes, and other cancers. Coronary artery disease was found to increase the risk of recurrence (P < .001).
“KRAS G12V mutation was associated with increased risk of recurrence in stage I NSCLC [and] any EGFR mutation was associated with reduced risk of recurrence,” concluded Dr Libby et al. “These findings may have implications for cancer surveillance strategies and inform future treatment trials of stage I NSCLC.”
Source:
Libby DM, Libby LJ, Ma X, et al. Association of oncogene driver mutations with recurrence and survival in stage I non-small cell lung cancer. Clin Lung Cancer. Published online: November 13, 2024. doi: 10.1016/j.cllc.2024.10.016
