About Lung Cancer | Diagnosis | Biomarkers
KRAS-positive lung cancer, refers to any lung cancer that tests positive for a KRAS biomarker. The KRAS biomarker is present in approximately 15-25% of patients with non-small cell lung cancer (NSCLC).
KRAS belongs to a class of genes known as oncogenes. When mutated, oncogenes have the potential to cause normal cells to become cancerous. Many patients with lung cancer, including many of those who test positive for the KRAS biomarker, don’t have any signs or symptoms in the early stages, which is why many lung cancer patients are not diagnosed until the lung cancer is advanced.
KRAS gene mutations are somatic, which means they are acquired during a person’s lifetime and are present only in tumor cells. Somatic mutations are not inherited.
In addition, KRAS gene mutations are more frequent in white populations than in Asian populations:
Also, these mutations seem to be more common in people who’ve smoked or who have been exposed to asbestos.
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Patient and Advocate Terri Conneran speaks with researcher Dr. Jacob Kaufman, of The James Cancer Center at Ohio State University.
Comprehensive biomarker testing can determine whether a KRAS lung cancer mutation or another lung cancer mutation is present. If you receive a lung cancer diagnosis, the very first thing you should do is make sure your doctors have ordered comprehensive biomarker testing done on your lung cancer tumor. You should have this testing done and you should have the results before starting any treatment, including chemotherapy and/or immunotherapy.
The comprehensive biomarker testing will involve a biopsy of your lung cancer. This biopsy will remove tissue, which will then be tested for its genetic makeup, or biomarkers. In most cases, tissue that is obtained from the original biopsy for diagnosing the lung cancer is used.
NCI-Designated Comprehensive Cancer Centers and other academic centers are excellent choices for and have experience in comprehensive biomarker testing. You can also have the testing done by a commercial lab recommended by your physician.
Once the biomarker testing is complete, and KRAS-positive lung cancer has been determined, your medical team will recommend a course of treatment. If your lung cancer hasn’t yet spread and it’s in an early stage, you might be a candidate for surgery to have the lung cancer completely removed. Conversely, if your lung cancer is determined to be advanced, immunotherapy may be prescribed for you in addition to chemotherapy
If your lung cancer is in an early stage, you may be a candidate for surgery to have the lung cancer completely removed.
Chemotherapy for lung cancer treatment uses a drug (or a combination of drugs) that employs cell-killing medications (cytotoxic) to attack cancer cells.
Radiation therapy slows or stops tumor growth by damaging the DNA and stops cancer cells from dividing and growing. In many cases, radiation therapy kills all of the cancer cells, thus shrinking or eliminating tumors.
Many patients with advanced KRAS-positive lung cancer are responding well to immunotherapy.
Currently, there is one FDA-approved targeted therapy for specific KRAS-positive lung cancer patients, with more in clinical trials.
FDA granted accelerated approval to adagrasib, a RAS GTPase family inhibitor, for adult patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC) who have received at least one prior systemic therapy.
Approved for: NSCLC
Biomarkers: KRAS G12C
FDA Approval Date: 12/01/2022
Used in: Targeted Therapy
Sotorasib is the first treatment for adult patients with non–small cell lung cancer whose tumors harbor KRAS G12C mutations and who have received at least 1 prior systemic therapy.
Approved for: NSCLC
Biomarkers: KRAS G12C
FDA Approval Date: 12/26/2024
Used in: Targeted Therapy
Clinical trials are sometimes great options for lung cancer patients. If you are accepted into a clinical trial, you will be assigned to a treatment group. You will either receive an investigational drug or you will be randomized to receive the investigational drug or the best standard of care. The specifics of the clinical trial depend on whether you are in a first-in-human trial or a later phase trial. (Best standard of care is the best treatment that physicians are offering patients with that cancer.)
In addition, the care that is included in the clinical trial will be covered financially by the trial sponsor, and you may receive a new treatment that might become a best option for you. There may also be additional expenses that might not be covered by the trial sponsor, so please carefully read the Informed Consent agreement. Discuss any concerns with a trial coordinator prior to making your decision.
Antidote Match™ connects people with medical research studies, in the fastest and easiest way possible. All you need to do is answer a few questions, and they will find the right trials for you. You gain access to the latest medical developments and world-class care.
ClinicalTrials.gov is a database of privately and publicly funded clinical studies conducted around the world.
"Things are changing rapidly for the better for people with KRAS-positive lung cancer."
Dr. David Carbone of the James Cancer Center at The Ohio State University
