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August 1, 2026Thoracic CancerOpen Access

ctDNA Detection of Polyclonal KRAS Resistance in Adagrasib‐Treated NSCLC

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Authors

MCMarion CaumeilJVJulie A. VendrellSCSimon Cabello‐Aguilar

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Overview

Case report demonstrates ctDNA identifies KRAS resistance mutations earlier than imaging in NSCLC.

Key Points

  • The study aims to characterize the relationship between ctDNA monitoring and resistance to KRAS G12C inhibitors in NSCLC.
  • Conducted serial ctDNA monitoring using droplet digital PCR and targeted next-generation sequencing.
  • Monitored a 66-year-old woman with KRAS G12C mutant lung adenocarcinoma after treatment with adagrasib.
  • Evaluated radiologic progression using CT and MRI imaging alongside molecular progression.
  • Baseline KRAS G12C ctDNA declined from 6205.3 copies/mL to 3.2 copies/mL after 7 weeks, indicating response.
  • ctDNA levels increased to 21.1 copies/mL at month 4 and 315.2 copies/mL at month 6, confirming disease progression.
  • Three emergent KRAS mutations (G12D, G13D, Q61H) were identified, illustrating polyclonal resistance despite stable imaging.

Cite This Study

Caumeil et al. (2026) studied this question.

synapsesocial.com/papers/6a6da778e258b358b3c6c909https://doi.org/10.1111/1759-7714.70313
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