Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) Mutation Testing Trends, Prevalence, and Outcomes in Metastatic, Non-Squamous Non-Small Cell Lung Cancer (Non-SQ NSCLC) Patients in Queensland, Australia From 2014–2023

Navin Niranjan; Tracey Guan; Nitin Niranjan; Atefeh Taherian Fard; Danny R. Youlden; Robert Mason; Bryan A. Chan; Jasotha Sanmugarajah

doi:10.1111/1759-7714.70274

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Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) Mutation Testing Trends, Prevalence, and Outcomes in Metastatic, Non-Squamous Non-Small Cell Lung Cancer (Non-SQ NSCLC) Patients in Queensland, Australia From 2014–2023

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Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) Mutation Testing Trends, Prevalence, and Outcomes in Metastatic, Non-Squamous Non-Small Cell Lung Cancer (Non-SQ NSCLC) Patients in Queensland, Australia From 2014–2023

Navin Niranjan, Tracey Guan, Nitin Niranjan, Atefeh Taherian Fard, Danny R. Youlden, Robert Mason, Bryan A. Chan and Jasotha Sanmugarajah

Thoracic Cancer, Vol.17(7), pp.1-8

2026

DOI: https://doi.org/10.1111/1759-7714.70274

PMID: 41906287

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Abstract

KRAS protein (human)

molecular targeted therapy

nonsmall cell lung cancer

Background Kirsten rat sarcoma viral oncogene homolog (KRAS) is the most commonly mutated oncogene in solid tumors, detected in up to 30% of lung adenocarcinomas. This study aimed to address gaps in the literature by analyzing KRAS mutations (KRASM) in a large Australian population. Methods A total of 3982 patients with metastatic nonsquamous nonsmall cell lung cancer diagnosed via public hospitals were retrospectively analyzed from January 1, 2014 to December 31, 2023. Records were reviewed for evidence of KRASM testing, KRAS results, biopsy type, and programmed death-ligand 1 (PD-L1) status. KRASM testing rates were also compared to that of other commonly tested oncogenic mutations. Results KRASM testing was performed in 52.9% of eligible patients, improving from 1.9% in 2014 to 86.3% in 2023. KRASM was identified in 830 patients (39.4% of KRASM tested patients, 20.8% overall). The most common KRASM seen was 12th codon substitution of KRAS glycine to cysteine (G12C) followed by substitutions of glycine to valine (G12V) and glycine to aspartate (G12D). Patients harboring KRASM were significantly more likely to have smoked, be female, and have higher PD-L1 expression than their KRAS wild type (wt) counterparts. All-cause survival was higher at the 1-year (43.9% vs. 35.3%) and 5-year (12.4% vs. 8.9%) marks in KRAS wt patients compared to KRAS mt. Conclusion This study is the largest longitudinal analysis of KRASM testing conducted in Australia, with significant improvement in testing rates seen over the time period. Rates of KRASM and characteristics of Australian KRAS mt patients correspond with published literature.

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Title: Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) Mutation Testing Trends, Prevalence, and Outcomes in Metastatic, Non-Squamous Non-Small Cell Lung Cancer (Non-SQ NSCLC) Patients in Queensland, Australia From 2014–2023
Authors: Navin Niranjan (Corresponding Author) - Gold Coast Hospital
Tracey Guan - Metro South Health
Nitin Niranjan - Griffith University
Atefeh Taherian Fard - Metro South Health
Danny R. Youlden - Metro South Health
Robert Mason - Gold Coast Hospital
Bryan A. Chan - University of the Sunshine Coast
Jasotha Sanmugarajah - Gold Coast Hospital
Publication details: Thoracic Cancer, Vol.17(7), pp.1-8
Publisher: John Wiley & Sons, Inc.
Date published: 2026
DOI: 10.1111/1759-7714.70274
ISSN: 1759-7714
PMID: 41906287
Copyright note: © 2026 The Author(s). Thoracic Cancer published by John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Data Availability: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Organisation Unit: School of Health; Cancer Research Cluster
Language: English
Record Identifier: 991228952502621
Output Type: Journal article

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