2023 World Conference on Lung Cancer (Posters)-EP12.03. Previously Treated Advanced-Disease NSCLC KRAS G12C From a Canadian Multi-Institutional Real-World Evidence Database (CARMA)

EP12.03. Previously Treated Advanced-Disease NSCLC KRAS G12C From a Canadian Multi-Institutional Real-World Evidence Database (CARMA) - PDF(Abstract)

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This study presented real-world evidence from a Canadian multi-institutional database on previously treated advanced non-small cell lung cancer (NSCLC) patients with KRAS G12C mutations. KRAS G12C mutations are found in 25-30% of non-squamous cell NSCLCs. The standard of care for these tumors has been immune-checkpoint inhibition (ICI) with or without chemotherapy. In second-line and beyond, treatment with sotorasib and other KRAS G12C tyrosine-kinase inhibitors (TKIs) has been studied. This study aimed to capture the real-world treatment patterns and outcomes of patients with KRAS G12C-mutated NSCLC post-ICI.<br /><br />The analyzed population included NSCLC patients with KRAS G12C-mutated advanced disease, previously treated with ICI, and started on a subsequent line of therapy. The incidence of KRAS G12C mutation, overall survival (OS), and progression-free survival (PFS) were evaluated.<br /><br />Results showed that among the 101 analyzed patients, the median age at post-ICI treatment initiation was 66 years, and 58% were female. 50% of patients had KRAS G12C-mutated lung cancer. The proportion of KRAS-mutated advanced disease NSCLC lung cancers was 29% in the Canadian centers, with higher percentages in heavy-smoking regions.<br /><br />Overall, the OS from the time of post-ICI treatment initiation for the entire patient population was 12.6 months, and the PFS was 4.7 months. Receiving KRAS-targeted therapy was associated with improved PFS compared to chemotherapy-based regimens.<br /><br />Attrition data showed that 50% of patients were ineligible for the study analysis as they never received a subsequent line of treatment post-ICI. Poor performance status, rapid decline, and reluctance to undergo chemotherapy were common reasons for attrition.<br /><br />In conclusion, this study revealed relatively poor PFS and OS post-ICI treatment in Canadian patients with KRAS G12C-mutated advanced NSCLC. There is a need to improve patient outcomes in this population, potentially through the increased availability of KRAS G12C inhibitors at earlier lines of therapy.

Asset Subtitle

Luna Zhan

Meta Tag

Speaker Luna Zhan

Topic Metastatic NSCLC: Targeted Therapy - Other

Keywords

Canadian multi-institutional database

advanced non-small cell lung cancer

NSCLC patients

KRAS G12C mutations

immune-checkpoint inhibition

chemotherapy

sotorasib

tyrosine-kinase inhibitors

overall survival

progression-free survival