Characterization of distinct types of KRAS mutation and its impact on first‑line platinum‑based chemotherapy in Chinese patients with advanced non‑small cell lung cancer

We performed this retrospective study to investigate whether the KRAS mutation status and its subtypes could predict the effect of first‑line platinum‑based chemotherapy in Chinese patients with non‑small cell lung cancer (NSCLC). Patients received who had KRAS mutations were enrolled. Correlations between KRAS mutations, specific mutant subtypes and responses to chemotherapy were analyzed using Kaplan‑Meier and Cox proportional hazard methods. A total of 2,183 cases who received KRAS mutation detection were included. A total of 218 of these cases were indicated to have KRAS mutations. KRAS mutations were identified more commonly in males compared with females (P=0.035). The most common subtypes were G12C, G12D and G12V. Among 73 KRAS mutant patients and 100 EGFR/ALK/KRAS wild‑type patients with advanced NSCLC, KRAS‑mutant NSCLC patients had a significantly shorter progression‑free survival (P=0.007) compared with NSCLC patients with KRAS wild‑type. In addition, there was a shorter but marginally statistically significant progression‑free survival (PFS) in KRAS mutant patients with adenocarcinoma compared with those with non‑adenocarcinoma (P=0.051). In the KRAS mutant group, patients with the KRAS G12V mutation had the poorest PFS compared with non‑G12V mutant cases (P=0.045). In conclusion, KRAS mutation was a negative predictive factor of PFS in Chinese patients with advanced NSCLC who received first platinum‑based chemotherapy. Patients with KRAS G12V mutations exhibited the poorest PFS compared with those with other KRAS mutant types.