Impact of KRAS mutations on clinical outcomes of patients with advanced non-squamous non-small cell lung cancer receiving anti PD1/PDL1 therapy.

Abstract PurposeTo evaluate the impact of KRAS mutations on response and survival outcomes in mutated vs wild type KRAS advanced non squamous non small cell lung cancer patients treated with immune checkpoint inhibitors alone or in combination with chemotherapy. Patients and methodsWe retrospectively identified 119 patients, most of which (58%) were wild type. For each patient we evaluated overall survival (OS), progression free survival (PFS) and disease control rate (DCR). An exploratory analysis was performed among mutated patients to investigate the impact of specific KRAS mutations on response and survival outcomes. ResultsAfter a median follow-up of 10.3 months, the median OS was 14.9 months (95% CI 7.6 – 22.7) in wild type KRAS patients vs 14.7 months (95% CI 8.0 – 19.5) in mutated KRAS patients; p-value=0.529. No differences were also detected between two groups in terms of PFS and DCR. Patients with pG12C KRAS mutation reported survival and response outcomes that were not statistically different from those of patients with other KRAS mutations. ConclusionOur data confirmed that KRAS mutational status is not associated with survival and response outcomes in advanced non squamous NSCLC patients treated with immunotherapy alone or combined to chemotherapy.