{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:45Z","timestamp":1788416025353,"version":"build-2803163510"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>KRAS<\/jats:italic>\n                      mutations (KRAS\n                      <jats:sup>m<\/jats:sup>\n                      )represent the most common oncogenic drivers in non\u2013small cell lung cancer (NSCLC). However, molecular features and clinical implications of the less common, codon 13 mutations (\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X) remain poorly characterized. We conducted a retrospective study to characterize\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X-positive NSCLC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We reviewed patients\u2019 charts with KRAS\n                      <jats:sup>m<\/jats:sup>\n                      NSCLC treated at University of Iowa Health Care. Based on intent of therapy, patients were assigned to curative-intent (CI) or palliative-intent (PI) cohorts. Clinicopathologic data, co-mutation profiles, and outcomes were assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 108 CI and 100 PI patients were included.\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X accounted for ~10% of KRAS\n                      <jats:sup>m<\/jats:sup>\n                      NSCLC.\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X tumors were enriched for\n                      <jats:italic>STK11<\/jats:italic>\n                      ,\n                      <jats:italic>KEAP1<\/jats:italic>\n                      ,\n                      <jats:italic>NFE2L2<\/jats:italic>\n                      , and\n                      <jats:italic>TSC1\/2<\/jats:italic>\n                      co-mutations. In the CI cohort,\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X had the lowest 12-month disease-free survival (DFS) (41%), though\n                      <jats:italic>KRAS<\/jats:italic>\n                      subtype was not independently prognostic. Poor performance status, stage III disease, delayed treatment initiation, and not having\n                      <jats:italic>ATM<\/jats:italic>\n                      co-mutations were associated with inferior DFS.\n                      <jats:italic>TET2<\/jats:italic>\n                      alterations were associated with worse overall survival (OS). In the PI cohort,\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X had the lowest 12-month progression-free survival (PFS) (17%) and OS (27%) compared to other\n                      <jats:italic>KRAS<\/jats:italic>\n                      alterations. On multivariable analysis,\n                      <jats:italic>STK11<\/jats:italic>\n                      ,\n                      <jats:italic>TERT<\/jats:italic>\n                      , and\n                      <jats:italic>TSC1\/2<\/jats:italic>\n                      alterations remained independently associated with worse survival, while\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X and G12D tended to exhibit poorer OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>KRAS<\/jats:italic>\n                      G13X mutations represent a small but clinically meaningful subset of NSCLC defined by a distinctive co-mutation pattern. Outcomes appear driven predominantly by co-mutations. Combinational therapeutic strategies addressing these vulnerabilities can help improve outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1825959","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:23:30Z","timestamp":1788413010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and genomic characterization of KRAS G13X non-small cell lung carcinoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Benjamin J.","family":"Staum","sequence":"first","affiliation":[{"name":"HealthPartners Cancer Center at Regions Hospital","place":["Saint Paul, MN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachaita","family":"Lakra","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Dept. of Internal Medicine - University of Iowa Health Care","place":["Iowa City, IA, 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