2023 World Conference on Lung Cancer (Posters)-EP06.03. Clinical Impact of EGFR vs KRAS Mutations in Multifocal Lung Adenocarcinoma

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This study compared the clinical outcomes of patients with EGFR and KRAS mutations in multifocal lung adenocarcinoma. The researchers analyzed data from 241 patients who underwent surgery for EGFR (n=150) and KRAS (n=91) adenocarcinomas between 2008 and 2022. The study found that 70.7% of EGFR tumors and 30.8% of KRAS tumors were subsolid. In addition, 56% of both EGFR and KRAS tumors were multifocal.<br /><br />The results showed that patients with KRAS mutations had a higher prevalence of smoking history, larger dominant tumor size, higher stage, higher SUVmax, higher tumor mutation burden, and worse disease-free survival and overall survival compared to those with EGFR mutations. When specifically looking at patients with multifocal disease, there was a trend towards a difference in overall survival between EGFR and KRAS mutations, although it was not statistically significant.<br /><br />Furthermore, for patients with traceable multifocal disease, the median follow-up of unresected secondary nodules was 55 months. The study found that survival without progression of secondary nodules was significantly shorter for patients with KRAS mutations compared to those with EGFR mutations.<br /><br />Univariate analysis showed that dominant tumor size, tumor morphology, pStage, and KRAS mutations were significantly associated with progression-free survival of secondary nodules. However, multivariate analysis revealed that only KRAS mutation was independently associated with worse progression-free survival of secondary nodules.<br /><br />In conclusion, this study suggests that patients with KRAS mutations in multifocal lung adenocarcinoma have a worse prognosis compared to those with EGFR mutations. Secondary nodules also progress faster in patients with KRAS mutations. Therefore, patients with KRAS multifocal disease should anticipate a higher likelihood of requiring treatment for secondary nodules.

Asset Subtitle

Jiahao Jiang

Meta Tag

Speaker Jiahao Jiang

Topic Pathology & Biomarkers: Genetic Biomarkers

Keywords

clinical outcomes

EGFR mutations

KRAS mutations

multifocal lung adenocarcinoma

subsolid tumors

multifocal tumors

disease-free survival

overall survival

secondary nodules

prognosis