WCLC 2025 - Posters & ePosters-P2.06.20 Assessment of Molecular Testing in Stage IV Non-Small Cell Lung Cancer Patients Across American Oncology Network

P2.06.20 Assessment of Molecular Testing in Stage IV Non-Small Cell Lung Cancer Patients Across American Oncology Network

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This study from Tohoku University Hospital analyzed 291 cases of resected early-stage lung cancer from 2022 to 2024, focusing on the association between driver gene mutations—particularly KRAS—and pathological features. Using multigene panel testing (AmoyDx Pan Lung Cancer PCR Panel), mutations were identified, showing EGFR mutations in 37% and KRAS mutations in 14% of cases, with various other driver mutations represented at lower frequencies.<br /><br />Clinicopathological findings revealed that KRAS-mutated non-small cell lung cancers (NSCLC) exhibited less lymphatic invasion and notably fewer lymph node metastases (N1, N2) compared with KRAS-negative tumors. The lymphatic invasion rate in KRAS-mutated tumors was approximately 8%, and lymph node metastasis was found in only 5% of KRAS cases versus higher rates in non-KRAS mutations, suggesting a lower propensity for lymphatic spread. Conversely, KRAS-mutated tumors showed a trend towards more frequent pleural invasion, indicating that pleural dissemination rather than lymphatic metastasis might be a key invasion route for these cancers.<br /><br />The study discusses discrepancies in existing literature regarding KRAS mutation and lymph node metastasis rates but concludes that for early-stage resectable lung cancers, KRAS mutation is associated with less lymphatic spread and more pleural involvement. Given that KRAS mutations are generally linked to poorer prognosis, these findings imply that pleural invasion and dissemination may underlie the aggressive clinical behavior observed in KRAS-mutated NSCLC rather than lymphatic metastasis.<br /><br />In summary, this research suggests that KRAS-mutated resectable lung cancers tend to metastasize less through lymphatic pathways but are more prone to pleural invasion, which may influence disease progression and prognosis. These insights could inform tailored clinical management and surveillance strategies for patients with KRAS-mutated lung cancer.

Asset Subtitle

Taral Patel

Meta Tag

Speaker Taral Patel

Topic Pathology and Biomarkers

Keywords

Tohoku University Hospital

early-stage lung cancer

KRAS mutation

non-small cell lung cancer

driver gene mutations

multigene panel testing

lymphatic invasion

lymph node metastasis

pleural invasion

AmoyDx Pan Lung Cancer PCR Panel