Characterization of 164 patients with NRAS mutated non-small cell lung cancer (NSCLC).
Chemotherapy
Immune checkpoint inhibitors
NRAS
Non-small cell lung cancer (NSCLC)
Targeted therapies
Journal
Lung cancer (Amsterdam, Netherlands)
ISSN: 1872-8332
Titre abrégé: Lung Cancer
Pays: Ireland
ID NLM: 8800805
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
16
07
2023
revised:
04
10
2023
accepted:
05
10
2023
pubmed:
16
10
2023
medline:
16
10
2023
entrez:
15
10
2023
Statut:
ppublish
Résumé
NRAS mutations are observed in less than 1% of non-small cell lung cancer (NSCLC). Clinical data regarding this rare subset of lung cancer are scarce and response to systemic treatment such as chemotherapy or immune checkpoint inhibitors (ICI) has never been reported. All consecutive patients with an NRAS mutated NSCLC, diagnosed between August 2014 and November 2020 in 14 French centers, were included. Clinical and molecular data were collected and reviewed from medical records. Out of the 164 included patients, 106 (64.6%) were men, 150 (91.5%) were current or former smokers, and 104 (63.4%) had stage IV NSCLC at diagnosis. The median age was 62 years, and the most frequent histology was adenocarcinoma (81.7%). NRAS activating mutations were mostly found in codon 61 (70%), while codon 12 and 13 alterations were observed in 16.5% and 4.9% of patients, respectively. Programmed death ligand-1 expression level <1%/1-49%/≥50% were respectively found in 30.8%/27.1%/42.1% of tumors. With a median follow-up of 12.5 months, median overall survival (OS) of stage IV patients was 15.3 months (95% CI 9.9-27.6). No significant difference in OS was found according to the type of mutation (codon 61 vs. other), HR = 1.12 (95% CI 0.65-1.95). Among stage IV patients treated with platinum-based doublet (n = 66), ICI (n = 48), or combination of both (n = 10), objective response rate, and median progression free survival were respectively 45% and 5.8 months, 35% and 6.9 months, 70% and 8.6 months. NRAS mutated NSCLC are characterized by a high frequency of smoking history and codon 61 mutations. Further studies are needed to confirm the encouraging outcome of immunotherapy in combination with chemotherapy.
Sections du résumé
BACKGROUND
BACKGROUND
NRAS mutations are observed in less than 1% of non-small cell lung cancer (NSCLC). Clinical data regarding this rare subset of lung cancer are scarce and response to systemic treatment such as chemotherapy or immune checkpoint inhibitors (ICI) has never been reported.
METHODS
METHODS
All consecutive patients with an NRAS mutated NSCLC, diagnosed between August 2014 and November 2020 in 14 French centers, were included. Clinical and molecular data were collected and reviewed from medical records.
RESULTS
RESULTS
Out of the 164 included patients, 106 (64.6%) were men, 150 (91.5%) were current or former smokers, and 104 (63.4%) had stage IV NSCLC at diagnosis. The median age was 62 years, and the most frequent histology was adenocarcinoma (81.7%). NRAS activating mutations were mostly found in codon 61 (70%), while codon 12 and 13 alterations were observed in 16.5% and 4.9% of patients, respectively. Programmed death ligand-1 expression level <1%/1-49%/≥50% were respectively found in 30.8%/27.1%/42.1% of tumors. With a median follow-up of 12.5 months, median overall survival (OS) of stage IV patients was 15.3 months (95% CI 9.9-27.6). No significant difference in OS was found according to the type of mutation (codon 61 vs. other), HR = 1.12 (95% CI 0.65-1.95). Among stage IV patients treated with platinum-based doublet (n = 66), ICI (n = 48), or combination of both (n = 10), objective response rate, and median progression free survival were respectively 45% and 5.8 months, 35% and 6.9 months, 70% and 8.6 months.
CONCLUSION
CONCLUSIONS
NRAS mutated NSCLC are characterized by a high frequency of smoking history and codon 61 mutations. Further studies are needed to confirm the encouraging outcome of immunotherapy in combination with chemotherapy.
Identifiants
pubmed: 37839252
pii: S0169-5002(23)00931-5
doi: 10.1016/j.lungcan.2023.107393
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107393Informations de copyright
Copyright © 2023 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Simon Baldacci reports institutional funding for the present study for data storage and data management from Lille University Hospital; and financial support for manuscript writing from Edimark SAS. Julien Mazieres reports grants from AstraZeneca, Roche, Pierre Fabre; and financial support for participation to boards and for expertise from Merck, AstraZeneca, BMS, MSD, Roche, Novartis, Daiichi, and Pfizer. Jacques Cadranel reports grants for translational research and academic trial from AbbVie, Pfizer, and Sanofi; and financial and non-financial support for participation to boards of experts, presentations, educational events and attending meetings (ASCO and ESMO) from AMGEN, AstraZeneca, Boehringer Ingelheim, Daiichi, Jansen, MSD, Novartis, Pfizer, Takeda, Sanofi. Marion Ferreira reports non-financial support for meeting attending from AstraZeneca. Clotilde Descarpentries reports financial support for participation to presentation and to scientific committee from AstraZeneca. Camille Munck reports financial support for participation to presentation and expert bord from Sanofi and Novartis. Agathe Dehem, Florian Guisier, Maxime Boussageon, Denis Moro-Sibilot, Gérard Zalcman, Nicolas Girard, Marie Wislez, Eric Wasielewski, Ali Chour, Charles Ricordel, Claire Poulet, Clément Gauvain, and Alexis B. Cortot, declare that they have no known conflicts of interest that could have appeared to influence the work reported in this paper..