WCLC 2025 - Posters & ePosters-EP.06.42 Clinical Characteristics and Treatments of Patients With Advanced Non-Squamous NSCLC KRAS-Mutated With or Without STK11

EP.06.42 Clinical Characteristics and Treatments of Patients With Advanced Non-Squamous NSCLC KRAS-Mutated With or Without STK11

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This Danish nationwide study analyzed clinical characteristics, treatments, and survival outcomes in advanced non-squamous (NSQ) non-small cell lung cancer (NSCLC) patients harboring KRAS mutations (KRASm), with or without concurrent STK11 mutations (STK11m), diagnosed between 2017 and 2022. KRAS is a common oncogenic driver in NSQ NSCLC, but the prognostic impact of KRAS mutations remains unclear, partly due to co-mutations like STK11 which influence clinical heterogeneity and treatment response. Current KRAS inhibitors primarily target the G12C mutation, with effectiveness affected by co-mutations.<br /><br />Out of 9,822 advanced NSQ NSCLC patients, 1,934 had KRAS mutations without STK11 co-mutation, 90 had KRAS and STK11 co-mutations (KRASm STK11m), and 68 had STK11 mutations only. About 75% of patients lacked comprehensive molecular data, highlighting a need for systematic testing and reporting. PD-L1 expression ≥50% was seen in 36.9% of KRASm-only patients but was notably higher (69.1%) in KRASm STK11m patients.<br /><br />Treatment patterns showed that approximately 80% of KRASm STK11m patients received first-line therapy, including radiotherapy (22.3%), immunotherapy (18.5%), chemotherapy (18.2%), and combination chemo-immunotherapy (9.9%). However, 20% did not receive any first-line treatment.<br /><br />Survival outcomes in KRASm STK11m patients were poor, with median overall survival of 7.0 months and 6- and 12-month survival rates of 54.4% and 36.8%, respectively, consistent with previous literature indicating adverse prognosis in this subgroup.<br /><br />The study concludes that KRAS mutations are prevalent in profiled NSQ NSCLC patients, but lack of comprehensive molecular profiling hampers optimal treatment decisions. It emphasizes the importance of enhanced nationwide molecular testing and reporting to improve patient stratification and guide therapeutic strategies, especially considering the impact of co-mutations on treatment responses. The research was funded by AstraZeneca.

Asset Subtitle

Edyta Urbanska

Meta Tag

Speaker Edyta Urbanska

Topic Pathology and Biomarkers

Keywords

KRAS mutations

STK11 mutations

non-squamous non-small cell lung cancer

NSQ NSCLC

molecular profiling

PD-L1 expression

treatment patterns

survival outcomes

co-mutations impact

nationwide Danish study