中国当代医药2023，Vol.30Issue(36)：99-103,111,封3-封4,8.
KRAS突变晚期肺腺癌患者一线治疗的回顾性观察研究
Retrospective observation of first-line treatment in patients with ad-vanced lung adenocarcinoma with KRAS mutation
摘要
Abstract
Objective To retrospectively analyze first-line treatment outcomes in real-world patients with advanced/ad-vanced lung adenocarcinoma with KRAS mutation,which is prevalent in non-small cell lung cancer(NSCLC).Methods Patients diagnosed with KRAS mutation and wild advanced/advanced lung adenocarcinoma in Zhangzhou Affiliated Hospital of Fujian Medical University from January 2018 to December 2021 were selected as study subjects,and patients who had received at least one course of first-line treatment were selected.Treatment characteristics,molecular profiles,and the ef-fects of different treatments in the real world on overall survival(OS)and progression free survival(PFS)were analyzed.Re-sults According to the inclusion and exclusion criteria,92 patients with KRAS mutation and 164 patients with KRAS wild-type advanced lung adenocarcinoma were collected.The median age of the KRAS group was 64 years old,95.7%were male,91.3%were smokers.In the second-generation sequencing results,51.5%were KRAS G12C subtype group,and 48.5%were non-G12C subtype group.In the survival analysis,the median PFS of KRAS mutant group was compared with that of wild group(5.2 months vs.6.8 months,P=0.22),and the difference was statistically significant.Among subtypes,the difference of the median overall survival(mOS)of G12C and nonG12C groups was statistically significant(11.5 months vs.6.35 months,P=0.12).Of the five treatment groups,the KRAS mutation group and G12C group treated with an-tiangiogenic agents had the longest OS(single chemotherapyvs.antivascular drugs vs.immunotherapy vs.three-drug com-bination group vs.proprietary Chinese medicine:9.0 months vs.20.0 months vs.10.0 months vs.15.0 months vs.2.0 months,P＜0.001),the difference was statistically significant.The three-drug combination group had the highest treatment response rate and the longest survival(mOS not yet achieved)in the nonG12C group.Conclusion The prognosis of patients with KRAS mutation is worse than that of wild-type patients,and the survival prognosis of G12C subtype is better than that of non-G12C group.Patients with KRAS gene mutation respond well to the combination of antivascular drugs and im-munotherapy drugs.This study provides useful evidence for survival outcomes and optimal treatment options for first-line treatment of locally advanced/advanced lung adenocarcinoma with KRAS mutations.关键词
KRAS突变/肺腺癌/一线治疗/免疫检查点抑制剂/抗血管生成治疗Key words
KRAS mutation/Lung adenocarcinoma/First-line treatment/Immune checkpoint inhibitors/Anti-angiothera-peutic分类
医药卫生引用本文复制引用
李莹莹,詹丽芬,吴登鹏,周继光,黄源茂,吴雯,林小燕..KRAS突变晚期肺腺癌患者一线治疗的回顾性观察研究[J].中国当代医药,2023,30(36):99-103,111,封3-封4,8.基金项目
福建省科技计划项目(2019Y9032). （2019Y9032）
