TY - JOUR T1 - Plasmatic KRAS Kinetics for the Prediction of Treatment Response and Progression in Patients With KRAS-mutant Lung Adenocarcinoma JO - Archivos de Bronconeumología T2 - AU - Taus,Álvaro AU - Camacho,Laura AU - Rocha,Pedro AU - Hernández,Ainhoa AU - Longarón,Raquel AU - Clavé,Sergi AU - Fernández-Ibarrondo,Lierni AU - Salido,Marta AU - Hardy-Werbin,Max AU - Fernández-Rodríguez,Concepción AU - Albanell,Joan AU - Bellosillo,Beatriz AU - Arriola,Edurne SN - 15792129 M3 - 10.1016/j.arbr.2020.01.013 DO - 10.1016/j.arbr.2020.01.013 UR - https://www.archbronconeumol.org/en-plasmatic-kras-kinetics-for-prediction-articulo-S1579212921001269 AB - IntroductionKRAS is the most common driver mutation in lung cancer. ctDNA-based assessment offers advantages over tumor as a minimally invasive method able to capture tumor heterogeneity. Monitoring KRAS mutational load in ctDNA may be useful in the management of the patients. MethodsConsecutive patients diagnosed with KRAS mutant lung adenocarcinoma in the tumor biopsy were included in this study. Plasma samples were obtained at different time points during the course of the disease. KRAS mutations in plasma were quantified using digital PCR and correlated with mutations in tumor and with radiological response and progression. ResultsTwo hundred and forty-five plasma samples from 56 patients were analyzed. The rate of detection of KRAS mutations in plasma in our previously characterized KRAS-mutant cases was 82% overall, reaching 96% in cases with more than 1 metastatic location. The dynamics of KRAS mutational load predicted response in 93% and progression in 63% of cases, 33 and 50 days respectively in advance of radiological evaluation. Progression-free survival for patients in whom ctDNA was not detectable in plasma after treatment initiation was significantly longer than for those in whom ctDNA remained detectable (7.7 versus 3.2 months; HR: 0.44, p=0.004). ConclusionsThe detection of KRAS mutations in ctDNA showed a good correlation with that in tumor biopsy and, in most cases, predicted tumor response and progression to chemotherapy in advance of radiographic evaluation. The liquid biopsies for ctDNA-based molecular analyses are a reliable tool for KRAS testing in clinical practice. ER -