根據(jù)一項于2012年7月18日在線發(fā)表在Cancer期刊上的研究，就晚期肺腺癌患者而言,，基因KRAS突變就能夠預(yù)測更短的存活時間,。來自美國西北大學(xué)的Melissa L. Johnson博士和同事們在2002年到2009年期間評價了1036名晚期肺腺癌患者(59%為女性,；33%為從沒有吸過煙的人)體內(nèi)的基因EGFR和KRAS的突變狀態(tài),，并利用這些數(shù)據(jù)研究了KRAS突變的預(yù)后意義。
研究人員發(fā)現(xiàn)這些患者的平均年齡為65歲,，而且他們當(dāng)中81%的卡氏行為表現(xiàn)狀態(tài)(Karnofsky performance status)分?jǐn)?shù)為80或者更高,。在多變量分析之后，研究人員還發(fā)現(xiàn),，EGFR突變與更長的總生存期(風(fēng)險比為0.60,；P<0.001)相關(guān)聯(lián)，而KRAS突變與更短的存活時間(風(fēng)險比為1.21; P=0.048)相關(guān)聯(lián),。
研究人員寫道,，“總之，我們報道,，KRAS突變的存在是肺腺癌患者的一個不良預(yù)后因素,。鑒于攜帶KRAS突變的患者通常接受一種導(dǎo)致他們存活時間更短的臨床治療方案,，因此他們應(yīng)當(dāng)在臨床試驗中單獨地接受評估。我們建議在前期突變分析中應(yīng)當(dāng)將KRAS檢測與EGFR突變和EML4-ALK突變檢測一起進行以便能夠在診所鑒定出這些病人,。”(生物谷：Bioon.com)
本文編譯自KRAS mutations predict shorter survival in lung cancer
doi: 10.1002/cncr.27730
PMC:
PMID:
Association of KRAS and EGFR mutations with survival in patients with advanced lung adenocarcinomas
Melissa L. Johnson MD1,†,*, Camelia S. Sima MD2, Jamie Chaft MD3, Paul K. Paik MD3, William Pao MD6, Mark G. Kris MD3,5, Marc Ladanyi MD4, Gregory J. Riely MD
BACKGROUND: Lung adenocarcinomas can be distinguished by identifying mutated driver oncogenes, including epidermal growth factor receptor (EGFR) and KRAS. Mutations in EGFR are associated with both improved survival as well as response to treatment with erlotinib and gefitinib. However, the prognostic significance of KRAS has not been evaluated in large numbers of patients and remains controversial. For the current report, the authors examined the association of EGFR and KRAS mutations with survival among patients with advanced lung adenocarcinomas. METHODS: Data were analyzed from patients with advanced lung adenocarcinomas who had known EGFR and KRAS mutation status evaluated between 2002 and 2009. The collected clinical variables included age, sex, Karnofsky performance status, smoking history, and treatment history. Overall survival from the diagnosis of advanced disease was analyzed using Kaplan-Meier and Cox proportional hazard methods. RESULTS: In total, 1036 patients were evaluated, including 610 women (59%) and 344 never-smokers (33%). The median patient age was 65 years (range, 25-92 years), and the majority of patients (81%) had a Karnofsky performance status ≥80%. In multivariate analysis, EGFR mutations were associated with longer overall survival (hazard ratio, 0.6; P < .001), and KRAS mutations were associated with shorter survival (hazard ratio, 1.21; P = .048). CONCLUSIONS: KRAS mutations predicted shorter survival for patients with advanced lung adenocarcinomas. The presence of EGFR and KRAS mutations define distinct subsets of patients with lung adenocarcinomas and should be determined in patients when they are diagnosed with advanced disease. Clinical trial reports should include EGFR and KRAS mutation status along with other prognostic factors. Cancer 2012. © 2012 American Cancer Society.
