Genomic characteristics, survival, and prognostic analysis of advanced non-small cell lung cancer with KRAS mutations and brain metastases
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The brain is a common site of metastasis in lung cancer. However, data on the incidence of brain metastases (BM) and survival outcomes among patients with non-small cell lung cancer (NSCLC) harboring KRAS mutations, particularly those receiving tyrosine kinase inhibitors (TKIs), remain limited. This single-center retrospective study aimed to characterize the incidence of BM in patients with KRAS-mutant NSCLC and identify prognostic factors associated with survival. Methods: A total of 4,021 patients with advanced NSCLC hospitalized at Zhejiang Cancer Hospital between January 2017 and December 2024 were screened. The primary endpoint was overall survival (OS), defined as the interval from BM diagnosis to death or the last follow-up. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Prognostic factors associated with OS were evaluated using univariable and multivariable Cox proportional hazards regression analyses. Results: 13.7 months, P=0.02). Multivariate analysis identified age, immunotherapy, brain SRS, and Eastern Cooperative Oncology Group performance status (ECOG PS) as independent predictors of OS (all P<0.05). Conclusions: BM is associated with an unfavorable prognosis in patients with KRAS-mutant NSCLC. TP53 co-mutations and higher diagnosis-specific graded prognostic assessment (DS-GPA) scores were associated with improved OS. Immunotherapy and brain SRS were significantly associated with prolonged survival.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223302993