KRAS mutation and low PDL-1 expressor

[Jittery]

Anyone have experience dealing with stage 4 non small cell lung cancer, KRAS mutation and low PDL-1 expressor?

My husband had surgery just over a year ago where a tumour was removed in lower and middle right lung. He now has 10+ micro nodules in his left lung.

I realize this is a long shot. I’m new to this forum.

thanks.

[BridgetO]

Hi Jittery and welcome. I'm hoping you get some responses here! I'm especially interested in KRAS mutations; my cancer had that but it was Stage 1a and I needed only surgery (so far). 

Bridget O

[Roz]

Hi Jittery,

My masses were also the KRAS mutation and Stage IV. I had chemo after surgeries that removed lower left lobe and upper right lobe. I go every three months for CT scans. Last time they noticed a group of nodules that were new, and also some that had increased in size. I am in "wait and see" mode. 

There is not a targeted treatment for KRAS at this point. My guess is they would try to biopsy anything that was large enough and figure out a treatment plan after that. How big are his micro nodules. Is he also having CT scans regularly? What did the oncologist say?

 

Ro

[LaurenH]

Hi, Jittery,

I will reach out to some of our members who have experience with KRAS and ask them to share their experience in this thread. In the meantime, I would be happy to provide you with additional information about LUNGevity’s support programs and resources for caregivers.

Please keep us updated on how you and your husband are doing. We are here for you!

With gratitude,

Lauren
—
Digital Community Manager
LUNGevity Foundation

[Lisa Haines]

Jittery,

  It's really not as much of a long shot as you may think.

  I have Stage IV NSCLC, KRAS+, no other mutations.  Diagnosed 3/27/15-also had a Brain met and pulmonary embolism.  I had CyberKnife for the Brain met, followed by Chemo and actually reached NED the first summer and went on to Maintenance chemo.  A few months later the tumor suddenly grew and was quite aggressive, so my Onc sent me to Radiation followed by Opdivo (which at that time had recently been FDA approved as a second line treament).   I never had PDL1 testing (it was not a standard test in 2015) nor is it needed to use Opdivo or Tecentriq.   Tumor mutation burden (TMB) "may" be a better predictor or who has a positive response to Immunotherapy.   KRAS doesn't seem to play a role in whether or not patient's have a good response to Immunotherapy.  Opdivo (Nivolumab) saved my life and quickly shrank the tumor.   Now. I have only a tiny blip where the tumor was and have had not other tumors or nodes since then.  I am also now "off treatment" and have been since August 2016.  I'm Stable and doing well -- Now 28 months and counting!   Think positive and fight!!!

     Lisa

[afeldman43]

Hi, I know this is an old thread but I wonder if any of you had advice re KRAS and Stage IV NSCLC.  My mother-in-law was diagnosed October 2018 with Stage 3, N2, underwent chemo-radiation for 6 weeks.   In January she started durvamulab.  In addition to KRAS, she has a very high PDL1 expression (90%), but was not a smoker. 

Her lung tumor and lymph nodes now appear clear, but she had metastasis to her skull identified in May and now appears to have mets to her L4, which will be treated with targeted radiation, and may have another bone tumor in her skull.   Her oncologist is considering whether to change her immunotherapy drug as durva hasn't seemed to have helped as well as whether another round of chemo may be warranted.   

Curious if there was any connection between Opdivo and KRAS; or if you have any insights into KRAS related trials that could be worth considering.  We're in NYC, but I wonder if there's non-NYC institutions we should be connecting with.

Thanks so much for reading.  Sending lots of love and best wishes