Table of Contents
Lung Cancer International
Volume 2012, Article ID 587424, 6 pages
http://dx.doi.org/10.1155/2012/587424
Research Article

Mutated KRAS Is an Independent Negative Prognostic Factor for Survival in NSCLC Stage III Disease Treated with High-Dose Radiotherapy

1Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, 405 30 Gothenberg, Sweden
2Department of Oncology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
3Department of Pathology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
4Department of Cytogenetics, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden

Received 8 May 2012; Revised 10 July 2012; Accepted 14 August 2012

Academic Editor: Elisabeth Quoix

Copyright © 2012 A. Hallqvist et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The main attention regarding prognostic and predictive markers in NSCLC directs towards the EGFR-targeted pathway, where the most studied genetic alterations include EGFR mutations, EGFR copy number, and KRAS mutations. We wanted to explore the prognostic impact of mutated KRAS in the stage III setting treated with high-dose radiochemotherapy. Methods. Samples were obtained from patients participating in two prospective studies of locally advanced NSCLC receiving combined radiochemotherapy: the RAKET study, a randomized phase II study where patients were treated with induction chemotherapy (carboplatin/paclitaxel) followed by concurrent radiochemotherapy, and the Satellite trial, a phase II study with induction chemotherapy (cisplatin/docetaxel) followed by radiotherapy concurrent cetuximab. The samples were analysed regarding KRAS mutations, EGFR mutations, and EGFR FISH positivity. Results. Patients with mutated KRAS had a significantly inferior survival, which maintained its significance in a multivariate analysis when other possible prognostic factors were taken into account. The prevalence of KRAS mutations, EGFR mutations, and EGFR FISH positivity were 28.8%, 7.5%, and 19.7%, respectively. Conclusion. Mutated KRAS is an independent negative prognostic factor for survival in NSCLC stage III disease treated with combined radiochemotherapy. The prevalence of KRAS mutations and EGFR mutations are as expected in this Scandinavian population.