Kristen murine sarcoma oncogene (K-ras) is the second most frequently mutated gene in patients with non-small cell lungcancer (NSCLC) in China, with a mutation frequency of 9.8%; about 30% of which are G12C mutations. K-ras mutation isassociated with poor prognosis (compared to wild type, HR=1.5, P=0.002).

Clinical Significance
1. It is recommended to detect K-ras gene status before systemic treatment for patients with inoperable stage III and
IV NSCLC to guide the treatments according to molecular classification. If tissue samples are not available, circulating
tumor DNA can be considered for testing.
2. It is recommended to detect K-ras gene status for the potentially resectable group of metastatic colorectal cancer
before neoadjuvant chemotherapy or systemic treatment in the palliative care group. The mutation patients are
resistant to cetuximab, Panitumumab and anti-HER-2 therapies.

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