KRAS of Poor Prognostic Value in Patients With HIV, NSCLC

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Overall survival for patients with advanced non-small cell lung cancer was greater for those with EGFR mutations versus those with KRAS mutations.
Overall survival for patients with advanced non-small cell lung cancer was greater for those with EGFR mutations versus those with KRAS mutations.

Epidermal growth factor receptor (EGFR) mutation should be investigated in patients with both human immunodeficiency virus (HIV) and non-small cell lung cancer (NSCLC) due to its predictive and prognostic value, while Kirsten ras (KRAS) mutation is of poor prognostic value.1

NSCLC is the most common type of non-acquired immune deficiency syndrome-related malignancy responsible for death in patients with HIV. Although mutational status is extremely important for guiding treatment decisions in patients with NSCLC, there is limited evidence on the frequency of EGFR and KRAS mutations and their effect on NSCLC in HIV-infected patients.

For the study, researchers analyzed 63 tumor samples for EGFR and KRAS mutational status from 73 HIV-NSCLC cases. All samples were from patients who had been diagnosed between June 1996 and August 2013 in Paris, France.

Of those, 63% were advanced NSCLC, with 60 nonsquamous and 9 squamous cell carcinomas. EGFR and KRAS mutations were observed in 2 and 7 samples, respectively. However, using more sensitive molecular techniques, researchers observed KRAS mutations in 29% of samples.

Results showed that overall survival for patients with advanced NSCLC were greater than 30 months for those with EGFR mutations, less than 3 months for those with KRAS mutations, and 9 months for patients with wild-type EGFR and KRAS.

In multivariate analysis, researchers found that KRAS mutation (HR, 24; 95% CI, 4.1 - 140.2; P = .0004) and a CD4 cell count less than 200 cell/μL (HR, 3.1; 95% CI, 3.7 - 7.5; P = .01) were associated with poor prognosis.

Reference

  1. Créquit P, Ruppert A-M, Rozensztajn N, et al. EGFR and KRAS mutation status in non–small-cell lung cancer occurring in HIV-infected patients [published online ahead of print November 28, 2015]. Lung Cancer. doi: 10.1016/j.lungcan.2015.11.021.

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