2023 World Conference on Lung Cancer (Posters)-P2.09. Real World Efficacy and Safety of Sotorasib in U.S. Veterans with KRAS G12C Mutated Non-Small Cell Lung Cancer

P2.09. Real World Efficacy and Safety of Sotorasib in U.S. Veterans with KRAS G12C Mutated Non-Small Cell Lung Cancer - PDF(Abstract)

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This study analyzed the real-world efficacy and safety of sotorasib, a targeted therapy for KRAS G12C-mutated non-small cell lung cancer (NSCLC), in U.S. veterans. The CodeBreaK100 trial had previously shown positive results, but limited data existed on real-world outcomes. The study retrospectively identified 128 patients who received sotorasib through the U.S. Veterans Affairs (VA) between June 2021 and February 2023.<br /><br />Compared to the CodeBreaK100 cohort, the patients in this study were older and less fit, reflecting the veteran population. 98% of patients had a history of tobacco use, and 49% had received immune checkpoint inhibitors (ICIs) in the three months before starting sotorasib. Among the 92 patients assessed for response, the objective response rate (ORR) was 34% and the disease control rate was 71%. The median time to response was 2.4 months, with a median duration of response of 4.0 months.<br /><br />The median duration of treatment was 6.3 months, with a median progression-free survival (PFS) of 6.0 months and a median overall survival (OS) of 12 months from initiation of sotorasib. Factors associated with decreased PFS included male gender, decreased renal function, and specific mutations. Sotorasib was interrupted or dose reduced in 37% of patients and discontinued for toxicity in 25% of patients.<br /><br />The most common adverse events leading to sotorasib discontinuation, interruption, or dose reduction were diarrhea, hepatotoxicity, and pneumonitis. The receipt of ICIs within three months of starting sotorasib was associated with an increased rate of discontinuation, interruption, or dose reduction for toxicity.<br /><br />Overall, the results of this analysis showed similar response rates and survival outcomes compared to published trial data for sotorasib in KRAS G12C-mutated NSCLC. However, shorter durations of response and higher rates of sotorasib discontinuation, interruption, or dose reduction due to toxicity were observed in this real-world population. Further analysis is needed to understand the association between ICI use and sotorasib toxicity. This study represents the largest real-world experience of sotorasib in NSCLC to date.

Asset Subtitle

Katherine Zhou

Meta Tag

Speaker Katherine Zhou

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

sotorasib

KRAS G12C-mutated

non-small cell lung cancer

efficacy

real-world outcomes

veterans

response rate

progression-free survival

toxicity

ICI use