Wu, Jia-JunJia-JunWuLee, Po-HsinPo-HsinLeeZheng, Zhe-RongZhe-RongZhengHuang, Yen-HsiangYen-HsiangHuangTseng, Jeng-SenJeng-SenTsengHsu, Kuo-HsuanKuo-HsuanHsuYang, Tsung-YingTsung-YingYangSUNG-LIANG YUChen, Kun-ChiehKun-ChiehChenChang, Gee-ChenGee-ChenChang2022-09-062022-09-062022-06-170025-7974https://scholars.lib.ntu.edu.tw/handle/123456789/617820Kirsten rat sarcoma (KRAS) mutation (KRASm) is associated with poor prognosis in non-small cell lung cancer (NSCLC) patients. We have aimed to survey NSCLC patients harboring KRASm in Taiwan, where never-smoking lung adenocarcinoma predominates, and analyze the immune checkpoint inhibitor effect on NSCLC harboring KRASm.NSCLC patients with KRASm were enrolled and tested on programmed death-ligand 1 (PD-L1) expression using available tissue. We analyzed their clinical features, PD-L1 status, responses to ICIs, and overall survival (OS).We studied 93 patients with a median age 66.0 years, 23.7% of whom were women, and 22.6% were never-smokers. The results showed that G12C (36.6%) was the most common KRASm. In 47 patients with available tissue for PD-L1 testing, PD-L1 expression was positive in 66.0% of patients, while PD-L1 ≥50% was higher in ever-smokers (P = .038). Among 23 patients receiving ICI treatment, those with PD-L1 ≥50% experience a 45.5% response rate to ICI. There were benefits from ICI treatment on OS compared with no ICI treatment (median OS 35.6 vs 9.8 months, P = .002) for all of our patients, and for patients with PD-L1 ≥50% (median OS not-reached vs 8.4 months, P = .008). There were no differences in survival across different KRAS subtypes (P = .666).Never-smokers composed more than one-fifth of KRASm in NSCLC in Taiwan. A high PD-L1 expression was related to smoking history and responded well to ICI. ICI treatment improved the OS in NSCLC patients with KRASm, particularly those with PD-L1 ≥50%.enimmune checkpoint inhibitor; Kirsten rat sarcoma; lung cancer; never-smoker; programmed death-ligand 1; SMOKING; IMPACT; EGFR; FREQUENCY; EFFICACY; SUBTYPE; ROS1[SDGs]SDG3journal article10.1097/MD.0000000000029381357134422-s2.0-85132454174WOS:000812362100001https://api.elsevier.com/content/abstract/scopus_id/85132454174