Long-term survival in a patient with non-small cell lung cancer harboring KRAS G13C and TP53 co-mutations: case report and literature review

Abstract

KRAS mutations are frequent oncogenic drivers in non-small cell lung cancer (NSCLC). Although targeted therapies have revolutionized treatment for the G12C subtype, the G13C variant lacks approved specific agents and correlates with a poor prognosis. We report a 59-year-old male with locally advanced (stage IIIA) lung adenocarcinoma harboring concurrent KRAS G13C and TP53 mutations. Surgery was contraindicated due to poor pulmonary function. The patient received first-line and maintenance therapy comprising carboplatin/pemetrexed, camrelizumab, and Endostar/bevacizumab. This regimen was well-tolerated and yielded a progression-free survival (PFS) exceeding 55 months. Of note, following regional lymph node progression, re-challenge with the original combination restored disease stability. Our findings suggest that the combination of chemotherapy, immunotherapy, and anti-angiogenic agents may represent a viable therapeutic strategy for patients with KRAS G13C/TP53 co-mutated NSCLC. This case report suggests a potentially promising therapeutic strategy to improve long-term survival in this difficult-to-treat patient population.