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). The KRAS biomarker 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.
Once a person has been diagnosed with lung cancer, the “standard of care” practice is to test for a panel of biomarkers that could help to determine the treatment for that particular patient. This panel will include testing for EGFR, ALK, ROS1 and KRAS, among others. Determining which biomarker is helping to drive the cancer allows the medical care team to determine the best and most effective treatment for that specific patient.
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.
KRAS gene mutations are found in 15 to 25 percent of all lung cancer cases but they are more frequent in white populations than in Asian populations:
- 25-50% of whites with lung cancer have KRAS gene mutations
5-15% percent of Asians with lung cancer have KRAS gene mutations.
In addition, KRAS mutations seem to be more common in people who’ve smoked or who have been exposed to asbestos.
Testing for KRAS-positive lung cancer
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.
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.
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. It is best to follow the current guidelines recommended by The National Comprehensive Cancer Network (NCCN). The NCCN recommends that your tumor be tested for a full panel of biomarkers. It is a good idea to request thorough biomarker testing from your physician, for the very best options for treatment. It is important to wait for all biopsy test results to be returned before starting a treatment.
What are the best treatment options for KRAS-positive lung cancer?
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. If your lung cancer is determined to be advanced, immunotherapy may be prescribed for you.
In 2021, the Federal Drug Administration (FDA) approved sotorasib (Lumakras) for KRAS-G12C NSCLC. 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. There are also several targeted therapies for KRAS-positive lung cancer in clinical trials and they are showing very promising results so far.
Are Clinical Trials for KRAS an option?
Clinical trials are sometimes great options for patients with KRAS-positive lung cancer. If you are accepted into a clinical trial, you will either receive an investigational drug or be randomized to receive the investigational drug or the best standard of care, depending 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 considered “over and above the standard of care” usually will be covered financially by the trial sponsor. You may receive a new treatment that might become the 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.
How can I find a Clinical Trial?
Here are 2 ways to find clinical trials – working with your doctor, you might get a jump on a new and better treatment even before it is available to others. This can accelerate medical breakthroughs for everyone and helps to increase EGFR positive lung cancer life expectancy.
Search for Clinical Trials with Antidote Match™
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.
Is immunotherapy an option for KRAS-positive lung cancer?
Yes – many patients with advanced KRAS-positive lung cancer are responding well to immunotherapy.
I’ve Been Diagnosed with KRAS-positive Lung Cancer. What Should I do First?
If you’ve been diagnosed with KRAS-positive lung cancer, you should first find a thoracic oncologist that you trust and, perhaps, also get a second opinion. Cancer treatments these days are really complicated and very personalized, making it difficult for every doctor to know every possible treatment option. A second opinion is a way of bringing in another team member to help you navigate your lung cancer journey.
KRAS Lung Cancer Prognosis
For patients with KRAS-positive lung cancer, says Dr. David Carbone of the James Cancer Center at The Ohio State University, “Things are changing rapidly for the better.”