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Lung CancerJuly 2022

What the KRYSTAL-1 Trial Found — Adagrasib for KRAS G12C Lung Cancer

KRYSTAL-1 tested adagrasib, a twice-daily oral pill targeting the KRAS G12C mutation, in 116 people with previously treated advanced non-small cell lung cancer. The drug shrank tumors in nearly half of patients and had a meaningful effect on cancer that had spread to the brain.

What the trial was testing

The KRYSTAL-1 enrolled 116 patients with lung cancer. The study was sponsored by Mirati Therapeutics and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was initial testing (phase 2). Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

43% had measurable tumor shrinkage — and the drug reached cancer in the brain.

New England Journal of Medicine · 2022 · NCT03785249

These findings — that had tumor shrinkage on adagrasib in KRAS G12C non-small cell lung cancer — were published in the New England Journal of Medicine and represent the headline result of the study.

Researchers tracked outcomes across 116 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with lung cancer, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Adagrasib (Krazati) is FDA-approved for KRAS G12C-mutated non-small cell lung cancer that has progressed after at least one prior treatment and available now. KRAS G12C testing on tumor tissue determines eligibility. Adagrasib is the second drug in this class; some patients respond better to one than the other. Ask your oncologist about testing and options.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

Open lung cancer trials

RecruitingInterventional study

MDT-Based Umbrella Decision Model for Geriatric Lung Cancer Patients

This is a single-center, prospective, single-arm interventional study with historical control, designed to evaluate the clinical value of a multidisciplinary team (MDT)-based decision-making umbrella decision model in elderly patients with lung cancer. A total of 2,000 patients aged 60-90 years with newly diagnosed non-small cell or small cell lung cancer will be enrolled. Each patient will undergo comprehensive geriatric assessment and receive an individualized treatment plan formulated by an MDT comprising thoracic surgeons, geriatricians, oncologists, pulmonologists, rehabilitation therapists, and radiologists. Treatment options include surgery, ablation, stereotactic body radiotherapy (SBRT), neoadjuvant immunochemotherapy, targeted therapy, and best supportive care. The primary outcome is 3-year progression-free survival (PFS). Secondary outcomes include overall survival, objective response rate, quality of life (EORTC QLQ-LC43), incidence of adverse events (CTCAE v5.0), and healthcare economics. Historical controls (2014-2024) will be extracted from hospital records and matched using propensity score matching. The study aims to establish a standardized MDT pathway to improve treatment outcomes and reduce risks in the geriatric lung cancer population.

Chengdu, Sichuan, China
RecruitingSafety & dosing

First-in-human Study of Interferon-y PET Imaging to Assess Response to Immunotherapy

The goal of this clinical trial is to investigate the use of \[89Zr\]Zr-DFO-emapalumab as an IFN-γ PET imaging agent to detect lesions and response to therapy among treatment-naïve non-small cell lung cancer (NSCLC) patients. PET scans following the imaging agent will be completed prior to and about 30 days after starting immunotherapy.

Detroit, Michigan, United States