title: Identification of a KRAS mutation in a patient with non-small cell lung cancer treated with chemoradiotherapy and panitumumab.
abstract: RTOG 0839 is a Phase II study of pre-operative chemoradiotherapy with or without panitumumab in potentially operable locally advanced non-small cell lung cancer (NSCLC). The investigational agent, panitumumab, is an anti-epithelial growth factor receptor (EGFR) antibody that improves progression-free survival in chemorefractory metastatic colorectal cancer (mCRC). Recently, both KRAS mutational status (i.e., mutated or not) and subtype (i.e., activating or inactivating) have been shown to be predictive of response to anti-EGFR therapy in mCRC. However, in NSCLC, it is unknown if KRAS mutational status or subtype predict benefit to anti-EGFR therapies because of unique genetic and epigenetic factors unique to each cancer. We present a patient with stage III NSCLC containing a KRAS G12D activating mutation who had a partial pathologic response, with disappearance of a minor KRAS mutant clone. This case suggests possible eradication of the G12D KRAS lung cancer clones by concurrent chemoradiation with panitumumab.
authors.affiliation: Department of Radiation Oncology; Fox Chase Cancer Center; Philadelphia, PA USA.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Zaorsky
authors.forename: Yunguang
authors.initials: Y
authors.lastname: Sun
authors.forename: Zixuan
authors.initials: Z
authors.lastname: Wang
authors.forename: Joshua
authors.initials: J
authors.lastname: Palmer
authors.forename: Paolo M
authors.initials: PM
authors.lastname: Fortina
authors.forename: Charalambos
authors.initials: C
authors.lastname: Solomides
authors.forename: Maria
authors.initials: M
authors.lastname: Werner-Wasik
authors.forename: Adam P
authors.initials: AP
authors.lastname: Dicker
authors.forename: Rita
authors.initials: R
authors.lastname: Axelrod
authors.forename: Barbara
authors.initials: B
authors.lastname: Campling
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Evans
authors.forename: Scott
authors.initials: S
authors.lastname: Cowan
authors.forename: Bo
authors.initials: B
authors.lastname: Lu
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001483:Base Sequence; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000235:genetics / Q000628:therapy; D059248:Chemoradiotherapy; D004252:DNA Mutational Analysis; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics / Q000628:therapy; D008875:Middle Aged; D020125:Mutation, Missense; D017239:Paclitaxel / Q000008:administration & dosage; D000077544:Panitumumab; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D011859:Radiography; D016896:Treatment Outcome; D018631:ras Proteins / Q000235:genetics*
chemical_list: D000911:Antibodies, Monoclonal; C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D000077544:Panitumumab; D016190:Carboplatin; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins; D017239:Paclitaxel
keywords: EGFR; KRAS; biomarker; non-small cell lung cancer; panitumumab
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