title: Investigation of transrenal KRAS mutation in late stage NSCLC patients correlates to disease progression.
abstract: OBJECTIVE
  Using transrenal DNA to detect KRAS mutations in non-small cell lung cancer (NSCLC), the study addressed the clinical impact for longitudinal monitoring and prognostic value for disease outcome.
  
  
  METHODS
  Digital droplet PCR was used to detect the mutant DNA. A total of 200 NSCLC patients were recruited with varying molecular profiles. To ascertain the specificity of transrenal DNA to accurately profile the disease, primary tissues were compared. Subsequently, serial samplings were performed at different treatment cycles to gauge the predictive value.
  
  
  RESULTS
  Transrenal DNA was successfully detected in all 200 patients. Overall concordance rate for mutant KRAS DNA within urine specimens and primary tissue biopsies was 95% (k = 0.87; 95% CI: 0.82-0.95). Patients with positive results at baseline had lower median overall survival (OS) than the wildtype group. More importantly, longitudinal monitoring of urine specimens showed an increase in the quantity of transrenal DNA, which were highly associated with disease progression and outcome.
  
  
  CONCLUSIONS
  Our study showed a highly associative link to the patient's tumor KRAS profile. Monitoring its variations aided in stratifying patients with worse outcome. Urinary specimens that can be extracted non-invasively presents new opportunities to track patients with KRAS mutation undergoing therapy.
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Xiaojiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Meng
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Chuanhai
authors.initials: C
authors.lastname: Wang
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Fajiu
authors.initials: F
authors.lastname: Li
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Zhiyang
authors.initials: Z
authors.lastname: Zhu
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Liu
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shi
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Shi
authors.initials: S
authors.lastname: Chen
authors.affiliation: a Department of Respiratory Medicine , Wuhan No. 6 Hospital, Affiliated Hospital to Jianghan University , Wuhan , People's Republic of China.
authors.forename: Chenghong
authors.initials: C
authors.lastname: Li
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016133:Polymerase Chain Reaction; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics* / Q000652:urine; D015996:Survival Rate
chemical_list: C117307:KRAS protein, human; D016283:Proto-Oncogene Proteins p21(ras)
keywords: KRAS mutation; NSCLC; cell free DNA; circulating tumor DNA; liquid biopsy; transrenal DNA