Moreover, in the entire population, patients with TP53 mutation (11.0 months vs. 8.5 months, P=0.038), positive PD-L1 expression (9.0 months vs. 8.5 months, P=0.041), or common mutations such as KRAS G12C/G12D/G12V showed better PFS (PFS: 14.5 months vs. 8.0 months, P=0.045)....The patients were divided into two groups according to their timing of receiving immunotherapy, as 105 patients (63.3%) received first-line treatment (1L) and 61 (36.7%) received second-line and above treatment (2L+). The 1L group had better prognosis than the 2L+ group, reflected in ORR (50.5% vs. 29.5%, P=0.001), mPFS (13.5 months vs. 5.0 months, P < 0.001), and mOS (20.0 months vs. 11.0 months, P=0.004)....Bringing immunotherapy to first-line use in NSCLC patients with KRAS mutation might prolong their survival, and combination therapy is a preferable option compared to monotherapy.

We identified 137 patients with KRAS-mutant NSCLC treated with chemo-immunotherapy: 45% (62/137) had mutations in KRAS-G12C and 55% harbored non-G12C mutations (17% G12V, 15% G12D, 4% G12A, 4% G12S, 3% G13D). The median OS was 21 and 14 months for G12C and non-G12C patients, respectively (p = 0.24).