The following article features coverage from the European Society for Medical Oncology 2020 virtual meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Treatment of patients with advanced non-small cell lung cancer (NSCLC) with the KRASG12C mutation represents an unmet need due to lack of treatment and poor outcomes, according to results of a retrospective study presented at the European Society for Medical Oncology (ESMO) Virtual Congress 2020.

KRAS is the most frequently mutated gene in NSCLC, with the G12C mutation occurring in 13% of lung adenocarcinomas. The purpose of this study was to use real-world data to evaluate the clinical characteristics and outcomes of this population.

This retrospective study included 743 patients with advanced NSCLC with the KRASG12C mutation treated by the Flatiron Health Network between 2011 and 2019. In the Network, there were also 3957 patients with wild-type KRAS, EGFR, and ALK (“triple wild-type”), and 7069 patients with NSCLC overall. KRAS was sequenced using next-generation sequencing (NGS) as part of routine care.

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The median age of patients in the cohort was 68 years and 61% were female. The majority of patients were white (74%). NSCLC histology was nonsquamous in 91% of patients and 69% of patients had stage IIIB-IVB disease at diagnosis.

The frequency of sites of metastasis were similar between groups, except brain metastases occurred more frequently in disease with the KRASG12C mutation at 23.4% compared with 14.6% and 17.6% in triple wild-type and all NSCLCs, respectively.

The KRASG12C mutation was commonly comutated with STK11 and KEAP1 mutations, but not other established driver alterations such as ALK, EGFR, BRAF, or ROS1.

Systemic therapy was not administered to 20% of patients with the KRASG12C mutation, “highlighting the unmet need in this patient population,” the authors wrote.

Median overall survival among patients with the KRASG12C mutation was similar to patients with triple wild-type or all NSCLC at first-line therapy. However, median OS decreased in the KRASG12C mutation group compared with the other groups as lines of therapy increased.

The authors concluded that “these results, supported by others, highlight that patients with KRAS p.G12C mutant NSCLC remain in need for new, safer, and more efficacious treatment options.”

Disclosures: Two authors declared affiliation with industry. Please refer to the original abstract for a full list of disclosures.

Read more of Cancer Therapy Advisor‘s coverage of the ESMO Virtual Congress 2020 by visiting the conference page.


Aggarwal S, Whipple S, Hsu H, et al. Clinicopathological characteristics and treatment patterns observed in real-world care in patients with advanced non-small cell lung cancer (NSCLC) and KRAS G12C mutations in the Flatiron Health (FH)-Foundation Medicine (FMI) Clinico-Genomic Database (CGDB). Presented at: European Society for Medical Oncology (ESMO) Virtual Congress 2020; September 19-21, 2020. Abstract 1339P.