{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:15:58Z","timestamp":1788336958180,"version":"build-2803163510"},"reference-count":31,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chemo\u2013immunotherapy is the standard frontline treatment of advanced non\u2013squamous non\u2013small cell lung cancer (nsq\u2013NSCLC). Among oncogenic drivers, KRAS mutation accounts for approximately 25% of lung adenocarcinomas, with p.G12C being the most common variant. This study assessed clinical features and survival outcomes according to KRAS mutation in a real\u2013life population of nsq\u2013NSCLC patients treated with first\u2013line platinum\u2013pemetrexed\u2013pembrolizumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective\u2013prospective study including patients with nsq\u2013NSCLC who received first\u2013line platinum\u2013pemetrexed\u2013pembrolizumab from 4 September 2018 in 33 Italian Centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 765 patients included in this analysis, 121 (15.8%) had\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      p.G12C mutation, 201 (26.3%)\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      non\u2013p.G12C mutation and 443 (57.9%)\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      WT.\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      \u2013mutated patients had more frequently a history of smoking (90.6% vs 84.1%, p=0.012) and bone metastases (44.1% vs 35.9%; p=0.022) compared to\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      WT.\n                    <\/jats:p>\n                    <jats:p>\n                      Median Overall Survival (OS) was similar between\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      \u2013mutated and\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      WT patients (16.7 vs 18.2 months; adjusted Hazard Ratio [HR] 1.19, 95% Confidence Interval [CI] 0.95\u20131.50, p=0.132). No difference in OS was found between\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      p.G12C and\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      non\u2013p.G12C (15.9 vs 17.0 months, HR 0.93, 95% CI: 0.66\u20131.31, p=0.676).\n                    <\/jats:p>\n                    <jats:p>\n                      Median progression\u2013free survival was significantly shorter in\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      \u2013mutated compared to\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      WT patients (8.8 vs 10.8 months; adjusted HR 1.29, 95% CI 1.04\u20131.59, p=0.018), with no differences between\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      p.G12C and\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      non\u2013p.G12C (8.8 vs 8.8 months, HR 0.95, 95% CI: 0.70\u20131.30, p=0.756).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      mutation showed a potential negative predictive role in advanced nsq\u2013NSCLC treated with first\u2013line chemo\u2013immunotherapy. The impact of co\u2013mutations and post\u2013progression outcomes warrants further investigation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03008916261443123","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:30:41Z","timestamp":1777887041000},"page":"316-324","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of first-line chemo-immunotherapy in advanced non-squamous NSCLC according to\n                    <i>KRAS<\/i>\n                    status: An Italian real-world study"],"prefix":"10.1177","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-6703","authenticated-orcid":false,"given":"Alessandro","family":"Leonetti","sequence":"first","affiliation":[{"name":"Medical Oncology Unit, University Hospital of Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Callegari","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8090-770X","authenticated-orcid":false,"given":"Fabiana","family":"Perrone","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, University Hospital of Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Maglietta","sequence":"additional","affiliation":[{"name":"Clinical &amp; Epidemiological Research Unit, University Hospital of Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Bordi","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, University Hospital of Parma, Parma, 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