Characteristics of lung cancers harboring NRAS mutations

Kadoaki Ohashi, Lecia V. Sequist, Maria E. Arcila, Christine M. Lovly, Xi Chen, Charles M. Rudin, Teresa Moran, David Ross Camidge, Cindy L. Vnencak-Jones, Lynne Berry, Yumei Pan, Hidefumi Sasaki, Jeffrey A. Engelman, Edward B. Garon, Steven M. Dubinett, Wilbur A. Franklin, Gregory J. Riely, Martin L. Sos, Mark G. Kris, Dora Dias-SantagataMarc Ladanyi, Paul A. Bunn, William Pao

Research output: Contribution to journalArticlepeer-review

89 Scopus citations


Purpose: We sought to determine the frequency and clinical characteristics of patients with lung cancer harboring NRAS mutations. We used preclinical models to identify targeted therapies likely to be of benefit against NRAS-mutant lung cancer cells. Experimental Design: We reviewed clinical data from patients whose lung cancers were identified at six institutions or reported in the Catalogue of Somatic Mutations in Cancer (COSMIC) to harbor NRAS mutations. Six NRAS-mutant cell lines were screened for sensitivity against inhibitors of multiple kinases (i.e., EGFR, ALK, MET, IGF-1R, BRAF, PI3K, and MEK). Results: Among 4,562 patients with lung cancers tested, NRAS mutations were present in 30 (0.7%; 95% confidence interval, 0.45%-0.94%); 28 of these had no other driver mutations. 83% had adenocarcinoma histology with no significant differences in gender. While 95% of patients were former or current smokers, smoking-related G:C>T:A transversions were significantly less frequent in NRAS-mutated lung tumors than KRAS-mutant non-small cell lung cancer [NSCLC; NRAS: 13% (4/30), KRAS: 66% (1772/2733), P <0.00000001]. Five of 6 NRAS-mutant cell lines were sensitive to the MEK inhibitors, selumetinib and trametinib, but not to other inhibitors tested. Conclusion: NRAS mutations define a distinct subset of lung cancers (∼1%) with potential sensitivity to MEK inhibitors. Although NRAS mutations are more common in current/former smokers, the types of mutations are not those classically associated with smoking.

Original languageEnglish (US)
Pages (from-to)2584-2591
Number of pages8
JournalClinical Cancer Research
Issue number9
StatePublished - May 1 2013

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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