KRAS mutation

Portal Forums Lung/Thoracic Cancer NSCLC General NSCLC KRAS mutation

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January 4, 2018 at 1:23 pm  #1293701    

gigizabuk

After having multiple lung nodules monitored since 2011 and one hamartoma resected in 2012, I now have been diagnosed with a KRAS positive adenocarcinoma of the RUL. Lymph nodes negative on biopsy and PET scan. The latter indicates an SUB of 12.2 with activity only in the region of the multilobulated 2.9 x 1.7 cm mass in the RUL. Hoping for a Stage 1 with resection of the entire lobe. Can you shed some light if there are any new chemo or targeted therapies yet developed for KRAS mutations in case further therapy is needed beyond surgery? Also, is the recurrence rate higher with KRAS? Thanks

January 4, 2018 at 4:11 pm  #1293703    
JimC Forum Moderator
JimC Forum Moderator

Hi gigizabuk,

For the most part, KRAS mutation-positive adenocarcinoma has been treated with standard chemotherapy agents. In recent years, there have been some good, preliminary results for a class of drugs called MEK inhibitors: http://cancergrace.org/lung/2013/07/03/mek-inhibitor-update-asco-2013/

Currently, there are a number of trials with MEK inhibitors, at times in combination with other agents, for KRAS-positive patients. You can find some of those trials here: https://www.clinicaltrials.gov/ct2/results?cond=lung+cancer&term=mek+kras&cntry=US&state=&city=&dist=

Here’s hoping that surgical resection is all that is needed!

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

January 4, 2018 at 4:32 pm  #1293704    
JimC Forum Moderator
JimC Forum Moderator

Sorry, I didn’t address your second question about recurrence. When a tumor is removed, what we are hoping is that there are no cancer cells which have spread to other parts of the body and that the patient is cured by surgery alone. Recurrences happen when those cells, called micrometastases, are present in the bloodstream but have not yet formed visible nodules. Some cancers are more aggressive (and therefore more likely to metastasize quicker), but that can’t be predicted in advance. The five-year survival rate for resected stage I lung cancer is much better than for more advanced stages, and in fact it’s usually not felt necessary or helpful to add adjuvant (post-surgery) chemotherapy for stage I lung nodules of the size you describe.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

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