Russian Journal of BiotherapyRussian Journal of BiotherapyРоссийский биотерапевтический журнал1726-97841726-9792Publishing House ABV Press154610.17650/1726-9784-2026-25-1-19-27REVIEWОБЗОР ЛИТЕРАТУРЫReview ArticlePredictive value of the KRAS gene mutation variant and co-mutation status when using immunotherapy in patients with non-small cell lung cancerПредиктивное значение варианта мутации в гене KRAS и комутационного статуса при использовании иммунотерапии у больных немелкоклеточным раком легкогоhttps://orcid.org/0000-0002-9534-2729KazakovAleksey M.КазаковА. М.
Russian Federation
Kazakovich873@gmail.comhttps://orcid.org/0000-0002-3848-865XGordievMarat G.ГордиевМ. Г.
Russian Federation
Kazakovich873@gmail.comhttps://orcid.org/0000-0003-4469-502XLaktionovKonstantin K.ЛактионовК. К.
Russian Federation
Kazakovich873@gmail.comhttps://orcid.org/0000-0002-4573-8477KrutelevaSvetlana Yu.КрутелеваС. Ю.
Russian Federation
Kazakovich873@gmail.comhttps://orcid.org/0009-0003-8591-9947TkachevaDaria D.ТкачеваД. Д.
Russian Federation
Kazakovich873@gmail.comN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава РоссииMoscow Scientific and Practical Center for Laboratory Research of the Moscow City Health DepartmentГБУЗ г. Москвы «Московский научно-практический центр лабораторных исследований Департамента здравоохранения г. Москвы»N.I. Pirogov Russian National Research Medical University (Pirogov University), Ministry of Health of RussiaФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России (Пироговский Университет)30042026251192709072025Copyright ©; 2026, ABV-PressCopyright ©; 2026, АБВ-пресс2026ABV-PressАБВ-прессhttps://creativecommons.org/licenses/by/4.0https://bioterapevt.abvpress.ru/jour/article/view/1546

Background. Predicting the disease course and response to various types of drug therapy is an important aspect of treating non-small cell lung cancer (NSCLC). With the rapid development of various molecular genetic testing options, particularly next-generation sequencing, it has become possible to obtain data on a large number of genetic abnormalities simultaneously. This wealth of information on the molecular genetic characteristics of tumors has become available for analysis and subsequent synthesis of data regarding the effectiveness of specific systemic therapies in each individual case, depending on the patient’s mutation status.

Aim. To evaluate the impact of KRAS mutations, such as KRAS G12C, G12D, G12V, and G12A, as well as the most common co-mutations with KRAS, on the effectiveness of immunotherapy in the treatment of lung adenocarcinoma.

Materials and methods. Collection and analysis of data from foreign and domestic literature on the prognostic significance of the comutation status of patients with KRAS-mutated NSCLC, mainly over the past 5 years. Sources were searched in the PubMed, Cochrane Library, and eLibrary abstract databases. Detailed information on the prognostic significance of the co-mutation status of patients with KRAS-mutated NSCLC is presented. It has been shown that different KRAS mutations, along with various co-mutations, have different impacts on the efficacy of immunotherapy, making expanded genetic testing of NSCLC a relevant and in-demand task with practical application.

Conclusion. Determining the co-mutation status of NSCLC patients, particularly the KRAS gene status in combination with other mutations such as TP53, STK11, KEAP1, and others, is crucial for determining sensitivity to immunotherapy and prognosticating the disease course. This field is actively developing both in Russia and internationally, demonstrating its potential and potential practical application.

Введение. Прогнозирование течения заболевания и ответа на различные виды лекарственной терапии является важным аспектом в лечении немелкоклеточного рака легкого (НМРЛ). С бурным развитием различных опций молекулярно-генетического тестирования, особенно секвенирования нового поколения, стало возможным получать данные о значительном числе генетических нарушений сразу. Большое количество информации о молекулярно-генетических особенностях опухоли стало доступно для анализа и последующего синтеза данных, касающихся эффективности той или иной системной терапии в каждом конкретном случае в зависимости от мутационного статуса пациента.

Цель исследования – оценка влияния наличия мутаций в гене KRAS, таких как KRAS G12C, G12D, G12V, G12A, а также наиболее частых комутаций, встречающихся одновременно с KRAS, на эффективность иммунотерапии при лечении аденокарциномы легкого.

Материалы и методы. Сбор и анализ данных зарубежной и отечественной литературы о прогностическом значении комутационного статуса пациентов с KRAS-мутированным НМРЛ преимущественно за последние 5 лет. Поиск источников осуществляли в реферативных базах данных PubMed, Cochrane Library, eLibrary. Показано, что различные варианты мутаций в гене KRAS одновременно с различными комутациями по-разному влияют на эффективность иммунотерапии, что делает расширенное генетическое тестирование НМРЛ актуальной и востребованной задачей, имеющей прикладное значение.

Заключение. Определение комутационного статуса у пациентов с НМРЛ, особенно статуса гена KRAS в комбинации с другими мутациями, такими как TP53, STK11, KEAP1 и прочими, чрезвычайно важно для оценки чувствительности к иммунотерапии и прогнозирования течения заболевания. Данное направление активно развивается как в России, так и за рубежом, что говорит о его перспективности и прикладном значении.

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