KRAS Mutation Lung Cancer
January 1, 1970
What is KRAS lung cancer?
KRAS (pronounced k-raz) is another gene that can produce a biomarker — that is, a feature of a cancer cell that targeted therapy drugs can see, so they can then find and destroy the cancer. KRAS is the most common genetic cause for non-small cell lung cancer, appearing in up to 25% [TRUE?] of cases. However, it has been one of the hardest to treat until very recently.It is more common in people who smoke or who used to smoke tobacco, and in people of Western European ancestry. KRAS is short for Kirsten RAt Sarcoma, the virus where the biomarker was first found in the 1980s.Like other biomarkers for non-small cell lung cancer (NSCLC), a healthy KRAS gene normally produces a protein that helps tell cells when to grow and when to stop growing. But in rare cases, the gene can change (mutate) its DNA by mixing with another healthy cell to become an oncogene. These are mutated genes that cause the out-of-control cell growth we call cancer. There are several kinds of KRAS mutations, but the KRAS G12C type happens in about half of the people with KRAS lung cancer.When the mutation takes place in the lungs, the mutant KRAS gene makes a damaged protein that causes NSCLC (it cannot cause small cell lung cancer). This bad KRAS protein on the surface of the cancer cell is what marks it, so targeted therapy drugs can see and kill it. Treating KRAS cancers with immunotherapy may prove more successful than using targeted therapies, but depending on the type and stage of your KRAS-positive NSCLC, targeted therapies and other cancer treatments can be effective alone or when combined with other treatments.H2: How is a KRAS mutation diagnosed? If you have symptoms or feel like something might be wrong with your health, see your doctor as soon as possible. If your symptoms are right for lung cancer, your healthcare team will diagnose the cause with modern imaging tools such as magnetic resonance imaging (MRI), computed tomography (CT), or positron emission tomography (PET) scans. If these scans show a mass or tumor in your lungs, the diagnosis is positive for lung cancer. Further testing will show the type of lung cancer and the best ways to treat it. As with most cancers, the sooner it is found, the better your chances for successful treatment.To know if a lung cancer has the KRAS mutation, laboratory biomarker testing is needed of a small sample of tumor tissue, or blood (known as a liquid biopsy). If the rearranged KRAS gene is found, your cancer will be called “KRAS positive.” Your treatment plan may include immunotherapy or targeted therapy drugs designed specifically to fight KRAS-positive lung cancer. Depending on how your cancer responds, you may also receive other treatments.H2: What are the symptoms of KRAS mutation in people with lung cancer? KRAS mutation lung cancer can cause several symptoms, and your healthcare team has ways to reduce how strong they are and how often they happen. If you have KRAS-positive lung cancer, it will show the same symptoms as any other non-small cell lung cancer. So, only biomarker testing can show the presence of KRAS mutation lung cancer.While some people will have few or no symptoms until the later stages of the disease, it’s important to tell your doctor quickly about any symptoms you may have before they become severe. Understanding how you’re feeling as you go through treatment will help your doctor fine-tune your treatment plan. This can help give you the best chance to be comfortable and to recover without unnecessary delays.Be sure to tell your doctor if you:
- Wheeze while breathing
- Have a cough that won’t go away
- Feel tired or weak
- Have a hoarse voice
- Feel chest pain that worsens when laughing, coughing, or breathing deeply
- Feel out of breath
- Lose weight for no known reason
- Cough up blood
If you are diagnosed with non-small cell lung cancer, talk to your doctor about biomarker testing, especially comprehensive next-generation sequencing (NGS). It looks for many different biomarkers with one test, and will show if you have KRAS mutation lung cancer. If you have any questions or concerns about your condition or treatment plan at any time, speak up and don’t be silent.H2: Treatment for KRAS Mutations in Lung Cancer While the new targeted therapies can work for KRAS mutation lung cancer, they are usually used after traditional radiation, chemotherapy, or surgery have been tried. Targeted drugs in pill form called KRAS inhibitors can interrupt the tumor’s out-of-control protein production that signals it to grow without stopping. These drugs won’t kill the cancer, but they can slow down its growth significantly.Like many medicines, KRAS inhibitors may lose effectiveness for some people over time due to drug resistance. This means the drug becomes less effective as the cancer cells evolve to resist its effects. If this happens, your doctor will help choose a different KRAS inhibitor or other treatments that will be more effective. In rare cases, people need to change drugs several times to avoid creating a drug resistant KRAS-positive lung cancer.This is part of why working closely with your cancer specialist is so important: to create an effective treatment plan that works for you, to watch your progress and symptoms, and to change your treatments as needed to keep you on track toward your goals.Drugs Targeting KRAS
- Krazati (adagrasib) – approved for locally advanced or metastatic NSCLC with a G12C change in KRAS as detected by a biomarker test following at least one line of systemic treatment such as chemotherapy.
- Lumakras (sotorasib) – approved for locally advanced or metastatic NSCLC with a G12C change in KRAS as detected by a biomarker test following at least one line of systemic treatment such as chemotherapy.
H2: Clinical Trials for and Research for KRAS Mutated Lung Cancer [BJ2] Taking an active part in your treatment and recovery can make a big difference in how well you feel, and how well your treatment goes. One of the ways you can do this is by taking part in a clinical research trial. People who participate may get new drugs or other treatments before they are available to the public, and everyone involved is helping to increase our understanding of lung cancer and how to beat it. You can find clinical trials online, and some can offer financial support. Your cancer specialist can also help you find trials that study KRAS-positive NSCLC, so you might someday help treat or cure the cancer that affects you and thousands of other people.H3. SPARK: Studying Pathways of Resistance in KRAS-driven Cancers SPARK is a research study to help understand drug resistance in KRAS-positive lung cancer. Anyone with KRAS-positive lung cancer who has been on a targeted therapy can participate. You will be asked for a small blood sample (liquid biopsy) which can be collected at home or by your local doctor. No tissue biopsy or travel is required.The blood sample will be studied to help treat KRAS-positive lung cancer. You and your healthcare team will receive a copy of the testing report, which could help guide your treatment decisions for your own cancer.Learn more and sign up to participate online or call 888-443-6952. Click here to see and download the SPARK study flyer.H2: Early Detection and Screening The KRAS mutation in lung cancer happens in about a quarter of all non-small cell lung cancers. Currently, there is no way to know if you are at high risk for the KRAS mutation before it happens and can be found with lab tests. However, a healthy diet and staying fit with exercise and a positive mental outlook are generally good for everyone. They can strengthen your immune system to help you avoid cancer, and give you a better chance to beat it if you do get it.As with all cancers, it is always better to find out you have it as soon as possible. Early detection means early treatment, and that can make a big difference in how well you do in the fight. Currently, only about a quarter of NSCLCs are caught before they spread to other parts of the body and become harder to treat. If you have symptoms of lung cancer, see your doctor immediately.To find out if a lung cancer is driven by KRAS or some other biomarker mutation, biomarker testing is needed. Either a liquid biopsy blood test or a comprehensive next generation sequencing report will show if the KRAS mutation is involved.H2: Support and Resources for People with Lung Cancer Click here to visit the GO2 for Lung Cancer HelpLine, where you can learn more about online resources, advocacy groups, support communities by and for people with lung cancer, and other groups that help people facing this disease. You can also visit the American Lung Association’s Lung Cancer Survivors page.Click the links below to get support online if you are fighting KRAS-positive lung cancer:
- Lung Cancer Survivors
- Request an KRAS-positive patient or caregiver mentor
- Lung HelpLine to talk to a healthcare professional
- Supportive/palliative care can help ensure your side effects are well controlled
Reach out and connect. These folks are qualified and eager to support you in your struggle against lung cancer.H2: Frequently Asked QuestionsHow common is KRAS lung cancer?Appearing in up to 25% of tumors, the KRAS mutation in lung cancer has been found in people of all different ethnic backgrounds. It is most common among those with Western European ancestry. Current or former smokers are also at higher risk for KRAS lung cancer. Why is KRAS hard to target with anti-cancer drugs?KRAS mutations have been hard to target due to the molecule’s very small size, smooth surface structure, with lack of binding sites. Nevertheless, two targeted drugs are available. Is KRAS mutation lung cancer hereditary?KRAS mutations happen during a person's lifetime and appear only in tumor cells. They cannot be inherited from your parents, or passed to your children. What is the KRAS mutation lung cancer survival rate?Late detection of lung cancers is common and can often lead to a poor outcome. Currently, advanced KRAS-mutant lung cancers have a median survival rate of just 1.2 years.
Lung cancer questions? Contact our free HelpLine at support@go2.org or 1-800-298-2436.