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The following is a summary of “Association of Oncogene Driver Mutations with Recurrence and Survival in Stage I Nonsmall Cell Lung Cancer,” published in the November 2024 issue of Pulmonology by Libby et al. 

Researchers conducted a retrospective study to evaluate new methods for risk stratifying patients with stage I nonsmall cell lung cancer (NSCLC) to identify those who might benefit from active surveillance or adjuvant therapy.  

They analyzed clinical data from 1,330 individuals (1,469 tumors) diagnosed with NSCLC and correlated it with next-generation sequencing (NGS). To minimize confounding factors related to stage and treatment, the analysis focused solely on patients with stage I NSCLC who underwent surgical resection as the primary treatment.  

The results showed that of 570 patients (600 tumors), 75 (12.5%) experienced recurrence. Recurrence was observed in 37.5% of those with KRAS G12V mutation, compared to 11.1% in those without (P < .001). “Any EGFR” mutation was linked to a lower recurrence rate (6.74% vs 14.9%, P = .006). A history of coronary artery disease (CAD) increased recurrence risk with an (OR) of 2.7 (1.57-4.89, P < .001). KRAS G12V (P = .009) and “other TP53” mutations (P = .025) predicted shorter survival. Oncogene mutations, including KRAS G12V, KRAS G13D, MET E168D, PTEN, and “other TP53,” were associated with reduced survival. Medical comorbidities such as CAD, type 2 diabetes (DM2), and “other cancer” were linked to poorer survival in stage I NSCLC.  

Investigators concluded the presence of oncogene mutations like KRAS G12V and EGFR in stage I NSCLC) might have significant implications for cancer surveillance and the design of future treatment trials. 

Source: pubmed.ncbi.nlm.nih.gov/39674767