Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005)
Introduction: Whereas interpatient heterogeneity in clinical characteristics and treatment outcomes of NSCLC harboring a KRAS mutation is recognized, the characterization of these patients in Asia has been limited. Methods: A multicenter, retrospective cohort study was conducted in eight academic ce...
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Elsevier
2022-01-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266636432100120X |
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| author | Jiyun Lee, MD Aaron C. Tan, BSc, M.B.B.S., PhD, FRACP Siqin Zhou, MSc Statistics Shinkyo Yoon, MD, PhD Siyang Liu, MD, PhD Ken Masuda, MD Hidetoshi Hayashi, MD, PhD Ullas Batra, MD, DM Dong-Wan Kim, MD, PhD Yasushi Goto, MD, PhD Sze Huey Tan, PhD Yi-Long Wu, MD Dae Ho Lee, MD, PhD Daniel S.W. Tan, BSc, M.B.B.S., MRCP, PhD Myung-Ju Ahn, MD, PhD |
| author_facet | Jiyun Lee, MD Aaron C. Tan, BSc, M.B.B.S., PhD, FRACP Siqin Zhou, MSc Statistics Shinkyo Yoon, MD, PhD Siyang Liu, MD, PhD Ken Masuda, MD Hidetoshi Hayashi, MD, PhD Ullas Batra, MD, DM Dong-Wan Kim, MD, PhD Yasushi Goto, MD, PhD Sze Huey Tan, PhD Yi-Long Wu, MD Dae Ho Lee, MD, PhD Daniel S.W. Tan, BSc, M.B.B.S., MRCP, PhD Myung-Ju Ahn, MD, PhD |
| author_sort | Jiyun Lee, MD |
| collection | DOAJ |
| description | Introduction: Whereas interpatient heterogeneity in clinical characteristics and treatment outcomes of NSCLC harboring a KRAS mutation is recognized, the characterization of these patients in Asia has been limited. Methods: A multicenter, retrospective cohort study was conducted in eight academic centers across Asia. Patients diagnosed with advanced NSCLC harboring a KRAS mutation and who had received at least one line of anticancer therapy between January 2014 and December 2018 were included. Modified time to next treatment (TTNT) was adopted as a proxy for progression-free survival. Results: A total of 216 patients were analyzed. The median age at diagnosis of advanced NSCLC was 63.3 years, 70.8% were men and 89.8% had adenocarcinoma. KRAS G12D was the most common subtype (25.5%), followed by G12C (24.5%), and G12V (19.4%) The proportion of current or former smokers was 65.7% in the overall population, with 86.8% in G12C and 58.9% in non-G12C subgroups. For all treatments combined for the total population, the first-line duration of therapy, modified TTNT, and TTNT were 4.5 (95% confidence interval: 3.4–5.9), 6.2 (4.9–8.8), and 9.5 (7.1–11.4) months, respectively. The median overall survival for the total population was 10.3 (6.9–12.4) months and was prolonged in patients ever treated with immunotherapy (14.6 [8.6–19.1] versus 7.0 [5.9–10.6] mo, hazard ratio = 0.54, p < 0.001), with left truncation to account for the time of KRAS testing. Conclusions: Whereas treatment outcomes with conventional anticancer therapy are reasonable and immunotherapy looks promising, the unmet need remains high for patients with KRAS-mutated NSCLC in Asia, underscoring the need for novel therapeutic approaches. |
| first_indexed | 2024-04-11T15:49:00Z |
| format | Article |
| id | doaj.art-45d393969fda454f81842b5e420fbb77 |
| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-04-11T15:49:00Z |
| publishDate | 2022-01-01 |
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| series | JTO Clinical and Research Reports |
| spelling | doaj.art-45d393969fda454f81842b5e420fbb772022-12-22T04:15:26ZengElsevierJTO Clinical and Research Reports2666-36432022-01-0131100261Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005)Jiyun Lee, MD0Aaron C. Tan, BSc, M.B.B.S., PhD, FRACP1Siqin Zhou, MSc Statistics2Shinkyo Yoon, MD, PhD3Siyang Liu, MD, PhD4Ken Masuda, MD5Hidetoshi Hayashi, MD, PhD6Ullas Batra, MD, DM7Dong-Wan Kim, MD, PhD8Yasushi Goto, MD, PhD9Sze Huey Tan, PhD10Yi-Long Wu, MD11Dae Ho Lee, MD, PhD12Daniel S.W. Tan, BSc, M.B.B.S., MRCP, PhD13Myung-Ju Ahn, MD, PhD14Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaDivision of Medical Oncology, National Cancer Centre Singapore, Singapore, SingaporeBiostatistics and Epidemiology Unit, Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, SingaporeDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, People’s Republic of ChinaDepartment of Thoracic Oncology, National Cancer Center Hospital, Tokyo, JapanDepartment of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, JapanDepartment of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, IndiaDepartment of Internal Medicine, Clinical Trials Center, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, KoreaDepartment of Thoracic Oncology, National Cancer Center Hospital, Tokyo, JapanBiostatistics and Epidemiology Unit, Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, Singapore; Biostatistics and Quantitative Epidemiology, Singapore Health Services, Singapore, Singapore; Oncology ACP, Duke-NUS Graduate Medical School, Singapore, SingaporeGuangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, People’s Republic of ChinaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDivision of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore; Corresponding author. Address for correspondence: Daniel S. W. Tan, BSc, M.B.B.S., MRCP, PhD, Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore 169610, Singapore.Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaIntroduction: Whereas interpatient heterogeneity in clinical characteristics and treatment outcomes of NSCLC harboring a KRAS mutation is recognized, the characterization of these patients in Asia has been limited. Methods: A multicenter, retrospective cohort study was conducted in eight academic centers across Asia. Patients diagnosed with advanced NSCLC harboring a KRAS mutation and who had received at least one line of anticancer therapy between January 2014 and December 2018 were included. Modified time to next treatment (TTNT) was adopted as a proxy for progression-free survival. Results: A total of 216 patients were analyzed. The median age at diagnosis of advanced NSCLC was 63.3 years, 70.8% were men and 89.8% had adenocarcinoma. KRAS G12D was the most common subtype (25.5%), followed by G12C (24.5%), and G12V (19.4%) The proportion of current or former smokers was 65.7% in the overall population, with 86.8% in G12C and 58.9% in non-G12C subgroups. For all treatments combined for the total population, the first-line duration of therapy, modified TTNT, and TTNT were 4.5 (95% confidence interval: 3.4–5.9), 6.2 (4.9–8.8), and 9.5 (7.1–11.4) months, respectively. The median overall survival for the total population was 10.3 (6.9–12.4) months and was prolonged in patients ever treated with immunotherapy (14.6 [8.6–19.1] versus 7.0 [5.9–10.6] mo, hazard ratio = 0.54, p < 0.001), with left truncation to account for the time of KRAS testing. Conclusions: Whereas treatment outcomes with conventional anticancer therapy are reasonable and immunotherapy looks promising, the unmet need remains high for patients with KRAS-mutated NSCLC in Asia, underscoring the need for novel therapeutic approaches.http://www.sciencedirect.com/science/article/pii/S266636432100120XKRASNon–small cell lung cancerAsianTime to next treatmentOverall survivalImmunotherapy |
| spellingShingle | Jiyun Lee, MD Aaron C. Tan, BSc, M.B.B.S., PhD, FRACP Siqin Zhou, MSc Statistics Shinkyo Yoon, MD, PhD Siyang Liu, MD, PhD Ken Masuda, MD Hidetoshi Hayashi, MD, PhD Ullas Batra, MD, DM Dong-Wan Kim, MD, PhD Yasushi Goto, MD, PhD Sze Huey Tan, PhD Yi-Long Wu, MD Dae Ho Lee, MD, PhD Daniel S.W. Tan, BSc, M.B.B.S., MRCP, PhD Myung-Ju Ahn, MD, PhD Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005) JTO Clinical and Research Reports KRAS Non–small cell lung cancer Asian Time to next treatment Overall survival Immunotherapy |
| title | Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005) |
| title_full | Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005) |
| title_fullStr | Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005) |
| title_full_unstemmed | Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005) |
| title_short | Clinical Characteristics and Outcomes in Advanced KRAS-Mutated NSCLC: A Multicenter Collaboration in Asia (ATORG-005) |
| title_sort | clinical characteristics and outcomes in advanced kras mutated nsclc a multicenter collaboration in asia atorg 005 |
| topic | KRAS Non–small cell lung cancer Asian Time to next treatment Overall survival Immunotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S266636432100120X |
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