THE RELATIONSHIP BETWEEN GENE MUTATIONS AND PROGNOSIS IN PATIENTS WITH STAGE I NON-SMALL CELL LUNG CANCER AFTER SURGERY
Volume 7, Issue 1, Pp 17-21, 2025
DOI: https://doi.org/10.61784/jpmr3029
Author(s)
Rui Ouyang, Ming Du*
Affiliation(s)
Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
Corresponding Author
Ming Du
ABSTRACT
This article discusses the relationship between gene mutations and prognosis in patients with stage I non-small cell lung cancer (NSCLC) after radical surgery. The study highlights that EGFR and ALK mutations are common in Stage I NSCLC patients and significantly affect both disease-free survival (DFS) and overall survival (OS). Patients with EGFR mutations respond well to EGFR-TKI treatment, significantly prolonging DFS; similarly, ALK mutation patients show improved prognosis with ALK inhibitor treatment. In contrast, patients with KRAS mutations have poorer outcomes, with common treatments including chemotherapy and immunotherapy. The importance of genetic testing in comprehensive postoperative treatment for early-stage NSCLC is highlighted, suggesting that individualized adjuvant therapy may play a role in improving long-term prognosis.
KEYWORDS
Non-small cell lung cancer; Gene mutation; EGFR; ALK; KRAS; Prognosis; Targeted therapy
CITE THIS PAPER
Rui Ouyang, Ming Du. The relationship between gene mutations and prognosis in patients with stage I non-small cell lung cancer after surgery. Journal of Pharmaceutical and Medical Research. 2025, 7(1): 17-21. DOI: https://doi.org/10.61784/jpmr3029.
REFERENCES
[1] Zhi X Y, Shi J G, Tian Y T, et al. Key points interpretation of the "2022 China Lung Cancer Patient Quality of Life White Paper". Chinese Journal of Thoracic and Cardiovascular Surgery, 2023, 30(08): 1083-1088.
[2] Wang X M. Advances in research on VEGFR-targeted tumor drugs. Biochemical Engineering, 2019, 5(03): 121-124.
[3] Herbst R S. Review of epidermal growth factor receptor biology. Int J Radiat Oncol Biol Phys, 2004, 59(2 Suppl): 21-26.
[4] Lee C K, Wu Y L, Ding P N, et al. Impact of specific epidermal growth factor receptor (EGFR) mutations and clinical characteristics on outcomes after treatment with EGFR tyrosine kinase inhibitors versus chemotherapy in EGFR-mutant lung cancer: a meta-analysis. J Clin Oncol, 2015, 33(17): 1958-1965.
[5] Reita D, Pabst L, Pencreach E, et al. Molecular mechanism of EGFR-TKI resistance in EGFR-mutated non-small cell lung cancer: application to biological diagnostics and monitoring. Cancers, 2021, 13(19): 4926.
[6] Feng J X, Liu N, Qin X T, et al. Clinical pathological characteristics and lymph node metastasis risk factors of stage I-III non-small cell lung cancer. Chinese Journal of Cancer Prevention and Treatment, 2021, 28(16): 1226-1230. DOI: 10.16073/j.cnki.cjcpt.2021.16.
[7] Wu Y L, Tsuboi M, He J, et al. Osimertinib in resected EGFR-mutated non-small cell lung cancer. N Engl J Med, 2020, 383(18): 1711-1723.
[8] Karachaliou N, Mayo C, Costa C, et al. KRAS mutations in lung cancer. Clinical Lung Cancer, 2013, 14(3): 205-214.
[9] Ren B R, Zhu Y J, Wang G H, et al. Study on the correlation between KRAS gene mutation and the expression levels of ERCC1 and TYMS mRNA in stage I-IIIA non-small cell lung cancer. Modern Biomedical Progress, 2016, 16(10): 1833-1837.
[10] Gadgeel S, Rodriguez-Abreu D, Felip E, et al. LBA5-KRAS mutational status and efficacy in KEYNOTE-189: Pembrolizumab (pembro) plus chemotherapy (chemo) vs placebo plus chemo as first-line therapy for metastatic non-squamous NSCLC. Ann Oncol, 2019, 30, xi64-xi65.
[11] West H J, McCleland M., Cappuzzo F, et al. Clinical efficacy of atezolizumab plus bevacizumab and chemotherapy in KRAS-mutated non-small cell lung cancer with STK11, KEAP1, or TP53 comutations: subgroup results from the phase III IMpower150 trial. J Immunother Cancer, 2022, 10(2).
[12] Kong J, Yang X, Kong H, et al. EGFR and ALK driver gene analysis in 2394 patients with lung adenocarcinoma. Journal of Nanjing Medical University (Natural Science Edition), 2020, 40(05): 675-680, 719.
[13] Paik J H, Choi C M, Kim H, et al. Clinicopathologic implications of ALK rearrangement in surgically resected lung cancer: a proposal of diagnostic algorithm for ALK-rearranged adenocarcinoma. Lung Cancer, 2012, 76(3): 403-409.
[14] National Health Commission of the People's Republic of China. Clinical application of respiratory system tumor drugs—2022 version of the new antitumor drug clinical application guidelines (Part 1). Exploration of Rational Drug Use in China, 2023, 20(4): 16-36.
[15] Jonna S, Subramaniam D S. Molecular diagnostics and targeted therapies in non-small cell lung cancer (NSCLC): an update. Discov Med, 2019, 27(148): 167-170.
[16] Pan Z C, Lin Y Z, Guo W C, et al. Meta-analysis comparing postoperative molecular targeted therapy and traditional chemotherapy in resectable non-small cell lung cancer patients. Chinese Journal of Cancer Surgery, 2020, 12(06): 560-563.
[17] Yuan Y Q, Wei L, Fang N N. Gene mutation analysis in non-small cell lung cancer in the Aksu region. Agricultural Reclamation Medicine, 2022, 44(06): 503-507.
[18] Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
[19] Wang C, Wu Y, Li J, et al. Distinct clinicopathologic factors and prognosis based on the presence of ground-glass opacity components in patients with resected stage I non-small cell lung cancer. Ann Transl Med, 2020, 8(18): 1133.
[20] Mokhles S, Macbeth F, Treasure T, et al. Systematic lymphadenectomy versus sampling of ipsilateral mediastinal lymph-nodes during lobectomy for non-small-cell lung cancer: a systematic review of randomized trials and a meta-analysis. Eur J Cardiothorac Surg, 2017, 51(6): 1149-1156.
[21] Palussière J, Chomy F, Savina M, et al. Radiofrequency ablation in stage IA non-small cell lung cancer in patients ineligible for surgery: results of a prospective multicenter phase II trial. J Cardiothorac Surg, 2018, 13(1): 91.
[22] Klein C A. Cancer progression and the invisible phase of metastatic colonization I. Nat Rev Cancer, 2020, 20(11): 681-694.
[23] Ziv E, Erinjeri J P, Yarmohammadi H, et al. The predictive value of KRAS gene mutation status in lung adenocarcinoma patients for local recurrence following image-guided ablation therapy. International Journal of Medical Radiology, 2017, 40(02): 213-214.
[24] Kelly K, Altorki N K, Eberhardt W E E, et al. Adjuvant erlotinib versus placebo in patients with stage IB-III A non-small-cell lung cancer (RADIANT): a randomized, double-blind, phase III trial. J Clin Oncol, 2015, 33(34): 4007-4014.