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Title Detection of KRAS G12/G13 Mutations in Cell Free-DNA by Droplet Digital PCR, Offers Prognostic Information for Patients with Advanced Non-Small Cell Lung Cancer
Author Michaelidou, Kleita
Author Koutoulaki, Chara
Author Mavridis, Konstantinos
Author Vorrias, Eleftherios
Author Papadaki, Maria A.
Author Koutsopoulos, Anastasios V.
Author Mavroudis, Dimitrios
Author Agelaki, Sofia
Abstract KRAS mutations are found in approximately one third of non-small cell lung cancer (NSCLC) patients. In this study, we aim to investigate whether KRAS G12/G13 mutant allele fraction (MAF) in cell-free DNA (cfDNA) can provide meaningful prognostic information in NSCLC. Multiplex droplet-digital PCR was used to quantitatively assess KRAS G12/G13 MAF in cfDNA from 114 pre-treated advanced disease NSCLC patients. In 14 patients, changes in KRAS G12/G13 MAF were longitudinally monitored during treatment. Plasma KRAS G12/G13 status was associated with poor patients’ outcome in terms of progression-free survival (PFS) (p < 0.001) and overall survival (OS) (p < 0.001). In multivariate analysis, the detection of plasma KRAS mutations was an independent predictor of adverse PFS (HR = 3.12; p < 0.001) and OS (HR = 2.53; p = 0.002). KRAS G12/G13 MAF at first treatment evaluation (T1) was higher (p = 0.013) among patients experiencing progressive disease compared to those with disease control, and increased KRAS MAF at T1 was associated (p = 0.005) with shorter PFS. On the contrary, no association was observed between tissue KRAS mutation status and patients’ prognosis. Our results show that ddPCR-based detection of KRAS G12/G13 mutations in plasma could serve as an independent biomarker of unfavorable prognosis in NSCLC patients. Changes in KRAS MAF can provide valuable information for monitoring patient outcome during treatment.
Language English
Subject Liquid biopsy
Molecular testing
Prognostic biomarker
Issue date 2020-11-20
Collection   School/Department--School of Medicine--Department of Medicine--Publications
  Type of Work--Publications
Notes European Commission Horizon 2020-Research and Innovation Program H2020-FETOPEN-1-2016-2017 (GA NUMBER-737212-Capturing non-Amplified Tumor Circulating DNA with Ultrasound Hydrodynamics (CATCH-U-DNA)).
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