2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP01.56

PP01.56 - Mansi Sharma

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This document presents a study on KRAS-mutated non-small cell lung cancer (NSCLC) in India, highlighting an unmet need for targeted therapies in this patient population. The study, conducted at the Rajiv Gandhi Cancer Institute and Research Centre, investigates the prevalence and types of KRAS mutations, co-mutations, and their clinical implications among metastatic NSCLC (mNSCLC) patients.<br /><br />Background information indicates that about 30-35% of NSCLC patients have KRAS mutations, often linked with specific clinical profiles. Effective targeting of these mutations has been challenging due to the molecular structure preventing drug binding, though recent developments like sotorasib and adagrasib have shown promise.<br /><br />The study involved a cross-sectional analysis of 640 patients who underwent next-generation sequencing (NGS), revealing a 21.5% positivity rate for KRAS alterations. Key KRAS mutations identified included G12D (21%), G12A (20%), G12C (17%), and several others. Co-mutations were also prevalent, with TP53 (52%), STK11 (24%), and KEAP1 (13%) being the most common. Notably, patients with STK11/KEAP1 co-mutations had slightly reduced overall survival, but this was not statistically significant due to smaller sample sizes.<br /><br />Importantly, none of the patients with KRAS G12C mutations received targeted therapies, emphasizing a lack of trial access or compassionate use in India. This study, the largest of its kind in India, suggests significant geographical differences in the prevalence and types of KRAS mutations compared to Western populations.<br /><br />The authors call for increased patient access to novel therapies and further research to characterize these mutations, noting a regional variation in mutation frequency and the need for more extensive studies to evaluate new drug efficacies. The study underscores the necessity for better drug availability through clinical trials and patient access programs.

Keywords

KRAS-mutated

non-small cell lung cancer

NSCLC

targeted therapies

India

Rajiv Gandhi Cancer Institute

next-generation sequencing

KRAS mutations

co-mutations

clinical trials