{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:55:10Z","timestamp":1791219310018,"version":"4.1.0"},"reference-count":56,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012353","name":"German Cancer Consortium","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012353","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Treatment of lung adenocarcinoma has changed and now includes checkpoint inhibitors (CPIs) or, in the case of an EGFR mutation, third-generation EGFR TKI osimertinib. Few data compare the long-term overall survival (OS) of current and historic subgroups. Methods: This real-world analysis (KOMPASS study) included stage IV lung-adenocarcinoma patients with either EGFR, KRAS, or no mutation. Patients were assigned to the \u201ccurrent\u201d EGFR, KRAS, or no-mutation cohort if they had mutation testing using NGS (n = 199; median date of diagnosis 2021). If they had an EGFR PCR test only, they were assigned to the \u201chistoric\u201d EGFR or no-mutation cohort (n = 127; median date of diagnosis 2014). Results: Both the current and the historic EGFR cohorts had significantly longer OS than the respective no-mutation cohorts (HR 0.58 and 0.60, respectively). The current no-mutation and EGFR cohorts had a strong trend to longer OS than the respective historic cohorts. In the no-mutation cohorts, the improvement was due to an increase in long-term survivors (HR 0.71), whereas in the EGFR mutation cohorts, the median OS was improved without long-term survivors (HR 0.70). The KRAS cohort showed OS like the no-mutation cohort, with a plateau of long-term survivors around 20%. Conclusions: A comparison of our data with that of the phase III trials KEYNOTE-189 and FLAURA suggests that the improved outcomes are due to the use of CPIs or osimertinib. The clinical trial results are well translated into real-world clinical practice with comparable OS. KRAS patients benefit from CPI treatment like no-mutation patients.<\/jats:p>","DOI":"10.3390\/cancers17071237","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T03:23:07Z","timestamp":1743996187000},"page":"1237","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends in Overall Survival in Lung Adenocarcinoma with EGFR Mutation, KRAS Mutation, or No Mutation"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2439-7538","authenticated-orcid":false,"given":"Martin","family":"Faehling","sequence":"first","affiliation":[{"name":"Clinic of Cardiology and Pneumology, Esslingen Hospital, 73730 Esslingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Fallscheer","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology and Pneumology, Esslingen Hospital, 73730 Esslingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Schwenk","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology and Pneumology, Esslingen Hospital, 73730 Esslingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Seifarth","sequence":"additional","affiliation":[{"name":"Clinic of Radiology, University of M\u00fcnster, 48143 M\u00fcnster, Germany"},{"name":"Clinic of Radiology, Esslingen Hospital, 73730 Esslingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0752-7169","authenticated-orcid":false,"given":"J\u00f6rn","family":"Str\u00e4ter","sequence":"additional","affiliation":[{"name":"Institute of Pathology, 73730 Esslingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5442-2805","authenticated-orcid":false,"given":"Claudia","family":"Lengerke","sequence":"additional","affiliation":[{"name":"University Hospital T\u00fcbingen, Department for Internal Medicine II, University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site T\u00fcbingen, a Partnership Between DKFZ and University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7966-8980","authenticated-orcid":false,"given":"Petros","family":"Christopoulos","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Thorax Clinic, 69126 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases, Heidelberg University Hospital, 69126 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,5]]},"reference":[{"key":"ref_1","unstructured":"World Cancer Research Fund (2024, April 06). 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