Immunohistochemical Loss of LKB1 Is a Biomarker for More Aggressive Biology in KRAS -Mutant Lung Adenocarcinoma

Calles, Antonio; Sholl, Lynette M.; Rodig, Scott J.; Pelton, Ashley K.; Hornick, Jason L.; Butaney, Mohit; Lydon, Christine; Dahlberg, Suzanne E.; Oxnard, Geoffrey R.; Jackman, David M.; Jänne, Pasi A.

doi:10.1158/1078-0432.ccr-14-3112

Cited by 115Lung Cancer Treatments and MutationsLung Cancer Research StudiesLung Cancer Diagnosis and Treatment

Immunohistochemical Loss of LKB1 Is a Biomarker for More Aggressive Biology in KRAS -Mutant Lung Adenocarcinoma

Calles, Antonio, Sholl, Lynette M., Rodig, Scott J., Pelton, Ashley K., Hornick, Jason L., Butaney, Mohit, Lydon, Christine, Dahlberg, Suzanne E. +3 more·2015·Clinical Cancer Research

DOI 10.1158/1078-0432.ccr-14-3112

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Abstract

Purpose: LKB1 loss is common in lung cancer, but no assay exists to efficiently evaluate the presence or absence of LKB1. We validated an IHC assay for LKB1 loss and determined the impact of LKB1 loss in KRAS-mutant non–small cell lung cancer (NSCLC). Experimental Design: We optimized and validated an IHC assay for LKB1 (clone Ley37D/G6) using a panel of lung cancer cell lines and tumors with known LKB1 mutations, including 2 patients with Peutz–Jeghers syndrome (PJS) who developed lung adenocarcinoma. We retrospectively analyzed tumors for LKB1 using IHC from 154 KRAS-mutant NSCLC patients, including 123 smokers and 31 never-smokers, and correlated the findings with patient and tumor characteristics and clinical outcome. Results: LKB1 expression was lost by IHC in 30% of KRAS-mutant NSCLC (smokers 35% vs. never-smokers 13%, P = 0.017). LKB1 loss did not correlate with a specific KRAS mutation but was more frequent in tumors with KRAS transversion mutations (P = 0.029). KRAS-mutant NSCLC patients with concurrent LKB1 loss had a higher number of metastatic sites at the time of diagnosis (median 2.5 vs. 2, P = 0.01), higher incidence of extrathoracic metastases (P = 0.01), and developed brain metastasis more frequently (48% vs. 25%, P = 0.02). There was a nonsignificant trend to worse survival in stage IV KRAS-mutant NSCLC patients with LKB1 loss. Conclusions: LKB1 IHC is a reliable and efficient assay to evaluate for loss of LKB1 in clinical samples of NSCLC. LKB1 loss is more common in smokers, and is associated with a more aggressive clinical phenotype in KRAS-mutant NSCLC patients, accordingly to preclinical models. Clin Cancer Res; 21(12); 2851–60. ©2015 AACR.

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LKB1 loss is prevalent in KRAS-mutant lung cancers, suggesting that oncogenic KRAS may upregulate one-carbon metabolism by undermining AMPK's inhibitory role in the folate cycle.
“Of note, LKB1 loss is prevalent in KRAS mutant lung cancers46, indicating that oncogenic KRAS not only induces mTOR activity, but might also upregulate one-carbon metabolism by undermining AMPK’s inhibitory role in the folate cycle.”
From The metabolic landscape of RAS-driven cancers from biology to therapy (2021) · cites this paper as [46]

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Salvianolic acid B acts against non‑small cell lung cancer A549 cells via inactivation of the MAPK and Smad2/3 signaling pathways
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STK11 (LKB1) immunohistochemistry is a sensitive and specific marker for STK11 adnexal tumours
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LKB1 Loss Assessed by Immunohistochemistry as a Prognostic Marker to First-Line Therapy in Advanced Non-Small-Cell Lung Cancer
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Self-citation
P2.09-28 Prognostic Impact of LKB1 Expression in Advanced Non-Small-Cell Lung Cancer
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Authors: Calles, A., Sholl, L. M., Rodig, S. J., Pelton, A. K., Hornick, J. L., Butaney, M., Lydon, C., Dahlberg, S. E., Oxnard, G. R., Jackman, D. M., & Jänne, P. A.
Affiliations: Dana-Farber Cancer Institute (US)
Brigham and Women's Hospital (US)
1Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
ORCID: Calles, Antonio
Sholl, Lynette M.
Rodig, Scott J.
Hornick, Jason L.
Butaney, Mohit
Dahlberg, Suzanne E.
Oxnard, Geoffrey R.
Venue: Clinical Cancer Research
Publisher: American Association for Cancer Research (AACR)
Published: 2015-06-14
Volume: 21
Issue: 12
Pages: 2851-2860
ISSN: 1078-0432 (ISSN-L)
1557-3265
DOI: 10.1158/1078-0432.ccr-14-3112
OpenAlex: W2129277646
Cited by: 115
References: 50
Citations by year: 2026: 2 · 2025: 12 · 2024: 7 · 2023: 9 · 2022: 14 · 2021: 16 · 2020: 12 · 2019: 11 · 2018: 10 · 2017: 6 · 2016: 13 · 2015: 3
FWCI: 8.45
Type: journal article
Language: en
Open access: closed
Locations: Clinical Cancer Research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Keywords: LKB1 loss, KRAS-mutant non-small cell lung cancer, lung adenocarcinoma, Peutz-Jeghers syndrome, smoking, metastasis, brain metastases, prognostic factors, tumor aggressiveness
MeSH terms: Adenocarcinoma of Lung, AMP-Activated Protein Kinase Kinases, Adenocarcinoma, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Female, Genotype, Humans, Immunohistochemistry, Lung Neoplasms, Male, Middle Aged, Mutation, Neoplasm Metastasis, Neoplasm Staging, Prognosis, Retrospective Studies, Risk Factors, Biomarkers, Proto-Oncogene Proteins p21(ras), Protein Serine-Threonine Kinases, Disease Progression, Cell Line, Tumor, Kaplan-Meier Estimate, Young Adult, High-Throughput Nucleotide Sequencing

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Immunohistochemical Loss of LKB1 Is a Biomarker for More Aggressive Biology in KRAS -Mutant Lung Adenocarcinoma

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