Background:
Oncogenic mutations in KRAS occur in approximately 26% and 11% of patients with lung adenocarcinoma in Western and Asian populations, respectively. 1-3 Until recently, there has been no licensed therapeutic targeting KRAS in patients with non–small cell lung cancer (NSCLC). That changed on May 28, 2021, when the United States Food and Drug Administration (FDA) granted accel- erated approval to sotorasib for second-line or later treatment of patients with locally advanced or metastatic KRAS G12C mutant NSCLC. This was the first FDA-approved targeted therapy for patients with KRAS mutant NSCLC, and it was based on a single-arm study demonstrating a promising objective response rate (37.1%), with a median duration of response of 11.1 months and median progression-free survival (PFS) of 6.8 months 4 among patients predominantly treated in the third line or later. There is a paucity of real-world data describing clinical outcomes in patients with locally advanced or metastatic KRAS G12C mutated NSCLC in the second-line or later, as most prior studies featured outcomes in the first line setting, evaluated specific patient subgroups, or evaluated the prognostic vs. predictive value of KRAS G12C compared to non-G12C genotypes. We sought to compile a large, academic medical center-based historical dataset to clarify clinical outcomes in the second line or later among patients with KRAS G12C mutant NSCLC.
Used by permission: Wade Iams, MD, Vanderbilt Ingram Cancer Center