Related Experiment Video
Updated: May 13, 2025
Next Generation Sequencing for the Detection of Actionable Mutations in Solid and Liquid Tumors
Published on: September 20, 2016
Trends in Overall Survival in Lung Adenocarcinoma with EGFR Mutation, KRAS Mutation, or No Mutation
Martin Faehling1, Sabine Fallscheer1, Birgit Schwenk1
1Clinic of Cardiology and Pneumology, Esslingen Hospital, 73730 Esslingen, Germany.
Background:
Treatment of lung adenocarcinoma has changed and now includes checkpoint inhibitors (CPIs) or, in the case of an EGFR mutation, third-generation EGFR TKI osimertinib. Few data compare the long-term overall survival (OS) of current and historic subgroups.
Methods:
This real-world analysis (KOMPASS study) included stage IV lung-adenocarcinoma patients with either EGFR, KRAS, or no mutation. Patients were assigned to the "current" EGFR, KRAS, or no-mutation cohort if they had mutation testing using NGS (n = 199; median date of diagnosis 2021). If they had an EGFR PCR test only, they were assigned to the "historic" EGFR or no-mutation cohort (n = 127; median date of diagnosis 2014).
Results:
Both the current and the historic EGFR cohorts had significantly longer OS than the respective no-mutation cohorts (HR 0.58 and 0.60, respectively). The current no-mutation and EGFR cohorts had a strong trend to longer OS than the respective historic cohorts. In the no-mutation cohorts, the improvement was due to an increase in long-term survivors (HR 0.71), whereas in the EGFR mutation cohorts, the median OS was improved without long-term survivors (HR 0.70). The KRAS cohort showed OS like the no-mutation cohort, with a plateau of long-term survivors around 20%.
Conclusions:
A comparison of our data with that of the phase III trials KEYNOTE-189 and FLAURA suggests that the improved outcomes are due to the use of CPIs or osimertinib. The clinical trial results are well translated into real-world clinical practice with comparable OS. KRAS patients benefit from CPI treatment like no-mutation patients.
Insights
Real-world data show that modern lung adenocarcinoma treatments, including checkpoint inhibitors (CPIs) and osimertinib, significantly improve overall survival (OS) compared to older methods. KRAS patients benefit from CPIs, similar to those without mutations.
Area of Science:
- Oncology
- Medical Research
- Clinical Practice
Background:
- Lung adenocarcinoma treatment has evolved with targeted therapies like osimertinib for EGFR mutations and checkpoint inhibitors (CPIs).
- Limited real-world data exist comparing long-term overall survival (OS) between current and historical patient subgroups.
Purpose of the Study:
- To compare the real-world overall survival (OS) of stage IV lung adenocarcinoma patients across different mutation statuses (EGFR, KRAS, no mutation) and treatment eras.
- To evaluate the impact of modern therapies (CPIs, osimertinib) on OS in lung adenocarcinoma.
Main Methods:
- The KOMPASS study analyzed real-world data from stage IV lung adenocarcinoma patients.
- Patients were categorized into 'current' (NGS testing, diagnosed 2021) and 'historic' (EGFR PCR only, diagnosed 2014) cohorts based on mutation testing and diagnosis date.
- Cohorts included EGFR-mutated, KRAS-mutated, and no-mutation groups.
Main Results:
- Both current and historic EGFR-mutated cohorts showed significantly longer OS than their respective no-mutation groups.
- Current no-mutation and EGFR-mutated cohorts trended towards longer OS than historic cohorts.
- OS improvement in no-mutation cohorts was linked to more long-term survivors, while EGFR cohorts saw improved median OS without a significant increase in long-term survivors.
- KRAS-mutated patients had OS similar to no-mutation patients, with approximately 20% long-term survivors.
Conclusions:
- Real-world outcomes align with phase III trials (KEYNOTE-189, FLAURA), indicating successful translation of CPIs and osimertinib into clinical practice.
- Modern treatments significantly improve OS in lung adenocarcinoma, comparable to clinical trial findings.
- KRAS-mutated lung adenocarcinoma patients demonstrate similar OS benefits from CPI treatment as patients without mutations.
More Related Videos
09:38Establishment and Characterization of Three Afatinib-resistant Lung Adenocarcinoma PC-9 Cell Lines Developed with Increasing Doses of Afatinib
Published on: June 26, 2019
09:38Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
Published on: August 11, 2017
Related Concept Videos
01:21Cancer Survival Analysis
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
02:38The Ras Gene
Ras is a...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
02:38Mitogens and the Cell Cycle