Background

• With the emergence of effective therapies targeting specific KRAS mutations (mt), identifying these unique KRAS mts in NSCLC has become increasingly relevant.
• Acquired KRAS mutations are a known resistance mechanism in driver mutation-positive (DM+) NSCLC.
• The incidence and diversity of these acquired alterations and whether they differ from those observed in de novo KRAS mt NSCLC is unknown.
• We aimed to characterize the distribution of KRAS mt between acquired and de novo KRAS mt NSCLC, as well as the distribution of unique KRAS mt by driver mutation.

Conclusions

• While the distribution of unique KRAS mutations did not differ significantly between DN and ACQ subgroups, acquired KRAS mutations at varying frequencies were seen across DM+ NSCLC subsets.
• The functional and immunological significance of these mutations, and their impact on clinical outcomes, warrants further investigation.