Abstract 714P
Background
Besides the well-known driver mutations, KRAS G12C is considered a promising therapeutic target in non-small cell lung cancer(NSCLC). In China, about 3% of NSCLC patients(pts) have KRAS G12C mutation. Currently, there is no target therapy approved for KRAS G12C in China and there is a lack of evidence regarding treatment patterns and clinical outcomes for this group of pts.
Methods
We performed a retrospective chart review of the electronic medical records of pts with stage IIIb-IV NSCLC harboring KRAS G12C mutation who received at least one systematic treatment in Shanghai Chest Hospital and Zhejiang Cancer Hospital between January 1, 2015, and September 30, 2022. Pts characteristics, treatment pattern, objective response rate (ORR), and real-world PFS (rwPFS) were analyzed. This is an interim analysis, and as of December 31, 2023, a total of 126 pts have been enrolled.
Results
Among 126 pts included, the median age was 57 yrs, with 121 (96.0%) being male pts. 72.3% of the pts had a history of smoking, 89.7% had adenocarcinoma, and 82.5% were in stage IV. PD-L1 testing was performed on 86 pts, among whom 33 (39.29%) had high expression (TPS≥50%), and 26 (30.95%) had low expression (TPS 1-49%). Out of 96 pts tested for STK11, 16 pts (16.7%) were mutated. First-line (1L) treatment information was available for 118 pts, of whom 35 received chemotherapy-based treatment (chemo), 18 received immunotherapy-based treatment (IO), 64 received chemotherapy plus immunotherapy (chemo+IO), and 1 pt received targeted therapy. The ORR for overall population was 19%, and for chemo, IO, chemo+IO were 11.43%, 27.78%, 21.88%, respectively; the median rwPFS for the three groups were 7.68months(m), 21m, and 12m (P=0.007), respectively. The rwPFS for 1L treatment in PD-L1 negative, low expression and high expression were 7.68m,7.25m, 17.18m. The rwPFS for 1L treatment in the STK11 mutation group vs. the non-mutation group was 3.25m vs. 9.64m (P<0.001).
Conclusions
The clinical efficacy of established current treatment options for NSCLC with KRAS G12C mutation remains suboptimal, and there is an urgent need for better treatment. This study will further collect more data to understand the clinical outcomes of this population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Novartis Pharmaceuticals, China.
Disclosure
All authors have declared no conflicts of interest.