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KRAS Mutated Non-Small Cell Lung Cancer: A Distinct Disease Entity?

Wouter W Mellema, MD1, Daniëlle AM Heideman, PhD2, Egbert F Smit, MD, PhD1, and Erik Thunnissen, MD, PhD2

In the era of personalized medicine, cancer research is focused on options for molecularly targeted treatment. In NSCLC, mutations in the gene that encodes the epidermal growth factor receptor (EGFR) and the translocation between the genes that encode echinoderm microtubule-associated protein-like-4 and anaplastic lymphoma kinase (EML4ALK) have been identified as predictive markers for particular targeted treatments, with good responses and outcomes in patients who receive these treatments [1,2]. On the other hand, there is no targeted treatment available for patients who have a mutation in KRAS, which is the most frequent mutation in patients with NSCLC. The question has been raised as to whether KRAS-mutated NSCLC can be considered as a distinct form of lung cancer. In this review, we try to answer this question by discussing the biology of KRAS mutation and its clinical behavior in respect of response to chemotherapy and outcome, and provide future perspectives of treatment of patients who have NSCLC with a KRAS mutation.

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