Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancer
Background: Approximately 30 % non-small cell lung cancer (NSCLC) patients carry KRAS mutations in western countries. First-line chemotherapy combined with immunotherapy has been the standard therapeutic regimen for KRAS-mutant NSCLC patients. This population could also benefit from chemotherapy com...
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Elsevier
2025-03-01
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| Series: | Translational Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1936523325000488 |
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| author | Huiping Qiang Yue Wang Yao Zhang Jingwen Li Lincheng Zhang Huawei Du Xuxinyi Ling Shuhui Cao Yan Zhou Runbo Zhong Hua Zhong |
| author_facet | Huiping Qiang Yue Wang Yao Zhang Jingwen Li Lincheng Zhang Huawei Du Xuxinyi Ling Shuhui Cao Yan Zhou Runbo Zhong Hua Zhong |
| author_sort | Huiping Qiang |
| collection | DOAJ |
| description | Background: Approximately 30 % non-small cell lung cancer (NSCLC) patients carry KRAS mutations in western countries. First-line chemotherapy combined with immunotherapy has been the standard therapeutic regimen for KRAS-mutant NSCLC patients. This population could also benefit from chemotherapy combined with anti-angiogenic therapy. However, few studies has reported on head-to-head efficacy comparisons between these two treatment strategies. Methods: We selected stage IV KRAS-mutated NSCLC patients diagnosed from 2017 to 2022. Their clinical baseline characteristics, first-line treatment strategy, whether combined TP53 or STK11 mutation, PD-L1 expression level, etc. were evaluated. The correlation between these factors and progression-free survival (PFS) and overall survival (OS) were analyzed. Results: A total of 273 patients received first-line systematic therapy. The most common mutation was KRAS G12C (34.3 %). First-line chemotherapy combined with immunotherapy brought significant survival benefits (mPFS: 11.0 months vs. 4.0 months, P = 0.0003; mOS: 17.0 months vs. 9.0 months, P = 0.0002) compared with first-line chemotherapy combined with anti-angiogenic therapy. Among the 203 patients who received first-line chemotherapy combined with immunotherapy, PD-L1 positive NSCLC patients responded better than PD-L1 negative patients (mPFS: 11.0 months vs. 4.0 months, P = 0.0004; mOS: 21.0 months vs. 11.0 months, P = 0.0005). ECOG PS score of 0–1 (HR=0.201, P = 0.001) and first-line chemotherapy combined with immunotherapy (HR=0.333, P = 0.009) were independent predictors of OS. Conclusions: Compared with first-line chemotherapy combined with anti-angiogenic therapy, first-line chemotherapy combined with immunotherapy has brought significant survival benefit to advanced KRAS mutant NSCLC patients, especially for PD-L1 positive patients. |
| format | Article |
| id | doaj-art-f08ccfc06ee548a5b6a31046793c0c27 |
| institution | Kabale University |
| issn | 1936-5233 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Translational Oncology |
| spelling | doaj-art-f08ccfc06ee548a5b6a31046793c0c272025-02-04T04:10:22ZengElsevierTranslational Oncology1936-52332025-03-0153102317Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancerHuiping Qiang0Yue Wang1Yao Zhang2Jingwen Li3Lincheng Zhang4Huawei Du5Xuxinyi Ling6Shuhui Cao7Yan Zhou8Runbo Zhong9Hua Zhong10Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaDepartment of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaCorresponding author at: Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, No.241, Huaihai West Road, Shanghai 200030, PR China.; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaCorresponding author at: Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, No.241, Huaihai West Road, Shanghai 200030, PR China.; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR ChinaBackground: Approximately 30 % non-small cell lung cancer (NSCLC) patients carry KRAS mutations in western countries. First-line chemotherapy combined with immunotherapy has been the standard therapeutic regimen for KRAS-mutant NSCLC patients. This population could also benefit from chemotherapy combined with anti-angiogenic therapy. However, few studies has reported on head-to-head efficacy comparisons between these two treatment strategies. Methods: We selected stage IV KRAS-mutated NSCLC patients diagnosed from 2017 to 2022. Their clinical baseline characteristics, first-line treatment strategy, whether combined TP53 or STK11 mutation, PD-L1 expression level, etc. were evaluated. The correlation between these factors and progression-free survival (PFS) and overall survival (OS) were analyzed. Results: A total of 273 patients received first-line systematic therapy. The most common mutation was KRAS G12C (34.3 %). First-line chemotherapy combined with immunotherapy brought significant survival benefits (mPFS: 11.0 months vs. 4.0 months, P = 0.0003; mOS: 17.0 months vs. 9.0 months, P = 0.0002) compared with first-line chemotherapy combined with anti-angiogenic therapy. Among the 203 patients who received first-line chemotherapy combined with immunotherapy, PD-L1 positive NSCLC patients responded better than PD-L1 negative patients (mPFS: 11.0 months vs. 4.0 months, P = 0.0004; mOS: 21.0 months vs. 11.0 months, P = 0.0005). ECOG PS score of 0–1 (HR=0.201, P = 0.001) and first-line chemotherapy combined with immunotherapy (HR=0.333, P = 0.009) were independent predictors of OS. Conclusions: Compared with first-line chemotherapy combined with anti-angiogenic therapy, first-line chemotherapy combined with immunotherapy has brought significant survival benefit to advanced KRAS mutant NSCLC patients, especially for PD-L1 positive patients.http://www.sciencedirect.com/science/article/pii/S1936523325000488Non-small cell lung cancerKRAS mutationImmune checkpoint inhibitorTP53PD-L1 |
| spellingShingle | Huiping Qiang Yue Wang Yao Zhang Jingwen Li Lincheng Zhang Huawei Du Xuxinyi Ling Shuhui Cao Yan Zhou Runbo Zhong Hua Zhong Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancer Translational Oncology Non-small cell lung cancer KRAS mutation Immune checkpoint inhibitor TP53 PD-L1 |
| title | Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancer |
| title_full | Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancer |
| title_fullStr | Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancer |
| title_full_unstemmed | Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancer |
| title_short | Efficacy of first-line chemotherapy combined with immunotherapy or anti-angiogenic therapy in advanced KRAS-mutant non-small cell lung cancer |
| title_sort | efficacy of first line chemotherapy combined with immunotherapy or anti angiogenic therapy in advanced kras mutant non small cell lung cancer |
| topic | Non-small cell lung cancer KRAS mutation Immune checkpoint inhibitor TP53 PD-L1 |
| url | http://www.sciencedirect.com/science/article/pii/S1936523325000488 |
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