The effects of bisphosphonate and radiation therapy in bone-metastatic lung adenocarcinoma: the impact of KRAS mutation.

Bone metastases KRAS mutation bisphosphonate therapy lung adenocarcinoma (LADC) radiation therapy

Journal

Translational lung cancer research
ISSN: 2218-6751
Titre abrégé: Transl Lung Cancer Res
Pays: China
ID NLM: 101646875

Informations de publication

Date de publication:
Feb 2021
Historique:
entrez: 15 3 2021
pubmed: 16 3 2021
medline: 16 3 2021
Statut: ppublish

Résumé

KRAS mutation is the most common genetic alteration in lung adenocarcinoma (LADC) in Western countries and is associated with worse outcome in bone-metastatic cases. Yet, to date, no effective treatment guidelines were developed for these patients. Accordingly, our aim was to investigate the impact of KRAS mutation on bisphosphonate (BTx) and radiation therapy (RTx) in bone-metastatic LADC patients. Clinicopathological variables of 134 consecutive LADC patients with bone metastases at diagnosis and known KRAS status were retrospectively analyzed. The effects of BTx, RTx and KRAS mutation on overall survival (OS) were investigated. Of the total cohort, 93 patients were identified as KRAS wild-type (WT) (69.4%) and 41 (30.6%) as KRAS mutant patients. The presence of KRAS mutation was associated with significantly reduced median OS (5.1 KRAS mutation is a strong negative prognostic factor in bone-metastatic LADC patients. Both BTx and RTx can increase the OS with a pronounced benefit for patients with KRAS WT tumors. Altogether, KRAS mutational status should be considered during therapeutic decision making in bone-metastatic LADC patients.

Sections du résumé

BACKGROUND BACKGROUND
KRAS mutation is the most common genetic alteration in lung adenocarcinoma (LADC) in Western countries and is associated with worse outcome in bone-metastatic cases. Yet, to date, no effective treatment guidelines were developed for these patients. Accordingly, our aim was to investigate the impact of KRAS mutation on bisphosphonate (BTx) and radiation therapy (RTx) in bone-metastatic LADC patients.
METHODS METHODS
Clinicopathological variables of 134 consecutive LADC patients with bone metastases at diagnosis and known KRAS status were retrospectively analyzed. The effects of BTx, RTx and KRAS mutation on overall survival (OS) were investigated.
RESULTS RESULTS
Of the total cohort, 93 patients were identified as KRAS wild-type (WT) (69.4%) and 41 (30.6%) as KRAS mutant patients. The presence of KRAS mutation was associated with significantly reduced median OS (5.1
CONCLUSIONS CONCLUSIONS
KRAS mutation is a strong negative prognostic factor in bone-metastatic LADC patients. Both BTx and RTx can increase the OS with a pronounced benefit for patients with KRAS WT tumors. Altogether, KRAS mutational status should be considered during therapeutic decision making in bone-metastatic LADC patients.

Identifiants

pubmed: 33718013
doi: 10.21037/tlcr-20-754
pii: tlcr-10-02-675
pmc: PMC7947398
doi:

Types de publication

Journal Article

Langues

eng

Pagination

675-684

Informations de copyright

2021 Translational Lung Cancer Research. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tlcr-20-754). The authors have no conflicts of interest to declare.

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Auteurs

Peter Radeczky (P)

Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, Budapest, Hungary.
National Koranyi Institute of Pulmonology, Budapest, Hungary.

Zsolt Megyesfalvi (Z)

Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, Budapest, Hungary.
National Koranyi Institute of Pulmonology, Budapest, Hungary.
Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Viktoria Laszlo (V)

National Koranyi Institute of Pulmonology, Budapest, Hungary.
Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Janos Fillinger (J)

Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, Budapest, Hungary.
National Koranyi Institute of Pulmonology, Budapest, Hungary.

Judit Moldvay (J)

National Koranyi Institute of Pulmonology, Budapest, Hungary.
MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Budapest, Hungary.

Erzsebet Raso (E)

2nd Department of Pathology, Semmelweis University, Budapest, Hungary.

Erzsebet Schlegl (E)

National Koranyi Institute of Pulmonology, Budapest, Hungary.

Tamas Barbai (T)

2nd Department of Pathology, Semmelweis University, Budapest, Hungary.

Jozsef Timar (J)

2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
Tumor Progression Research Group, Hungarian Academy of Sciences-Semmelweis University, Budapest, Hungary.

Ferenc Renyi-Vamos (F)

Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, Budapest, Hungary.
National Koranyi Institute of Pulmonology, Budapest, Hungary.

Balazs Dome (B)

Department of Thoracic Surgery, National Institute of Oncology-Semmelweis University, Budapest, Hungary.
National Koranyi Institute of Pulmonology, Budapest, Hungary.
Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Balazs Hegedus (B)

Department of Thoracic Surgery, Ruhrlandklinik, University Clinic Essen, Essen, Germany.

Classifications MeSH