Plasma KRAS Mutation in Indonesian Lung Cancer Patients with Smoking History, Treated with Chemotherapy

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Anticancer Agents
Thoracic Malignancies
Translational Research
Presenter najmiatul Masykura
Citation Annals of Oncology (2018) 29 (suppl_9): ix143-ix149. 10.1093/annonc/mdy446
Authors N. Masykura1, S. Andarini2, E. Syahruddin Spp K3, J. Zaini4, A. Hudoyo4, Y. Santoso5, A. Mirandari6, A.R. Utomo7
  • 1Cancer Division, Stem Cell and Cancer Institute (SCI), PT Kalbe Farma Tbk, 13210 - east jakarta/ID
  • 2-, RSUP Persahabatan, 13230 - Jakarta/ID
  • 3-, RS Persahabatan Hospital, 13240 - Jakarta/ID
  • 4-, RSUP Persahabatan, 132130 - Jakarta/ID
  • 5Biomedicine, Indonesia International Institute of Life-Sciences (i3L), 13210 - Jakarta Timur/ID
  • 6Biochemistry, Imperial College London, SW 7 AZ - London/GB
  • 7Stemcell And Cancer Institute, Pt. Kalbe Farma Tbk, Jakarta/ID



Some studies suggest that patients with KRAS mutations show inferior response to chemotherapy and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). Moreover, types of KRAS mutations may be associated with treatment outcome. In this study, we described KRAS mutations in plasma of NSCLC (Non Small Cell Lung Cancer) patients before and during chemotherapy.


Baseline cytology smears and plasma were collected from 51 of NSCLC patients. These samples were previously tested negative for EGFR mutations and therefore treated with chemotherapy. Cytology smears were collected before treatment, while plasma specimens were collected at 0, 3 and 6 months after treatment. Sixteen of 3-month follow-up and three of 6-month follow-up plasma specimens were available for analysis. We performed KRAS mutation test on these samples, using high resolution melting (HRM) analysis and DNA sequencing.


KRAS mutation frequency in baseline cytology samples was 11.76% (N = 51). One (N = 51, 1.96%) mutation case was also observed in the matched plasma sample. In 3-month follow-up plasma samples, KRAS mutations were detected in three patients with smoking history (25%, N = 12). We also found 1 KRAS mutation in 6-month follow-up plasma samples. All KRAS mutations were G12C subtypes.


KRAS mutations were detected in plasma of patient during standard chemotherapy. Furthermore, G12C subtype of KRAS mutation found in this study was consistent with the smoking history of the patients. Preliminary observation of plasma KRAS mutation found in this study might serve as an interesting biomarker to monitor outcome of lung cancer chemotherapy.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

PT. Kalbe Farma, Tbk.


PT. Kalbe Farma, Tbk.


All authors have declared no conflicts of interest.