Lung cancer treatment appears to be more and more “precision”. In particular if we are talking about non-small cell lung cancer (NSCLC, the most common), where often – 6 times out of 10 – mutations are identified that can be “targets” for targeted drugs. One of the most frequent is KRAS G12C, present more or less in one patient out of 8 (11-13%): in our country it is found in about 4,500 new cases a year. For patients with advanced lung cancer and this mutation, a new oral targeted drug, sotorasib, was approved by the European Commission in January. And now, from the American Association for Cancer Research congress, come the two-year follow-up data of the CodeBreaK 100 study (phase I / II), conducted on patients who had already received other treatments. Well: almost one in three patients is alive two years after treatment. And 40.7% of patients responded to therapy, with complete or partial tumor shrinkage.
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To understand what these numbers mean it must be said that, currently, for patients with NSCLC and the KRASG12C mutation in whom first-line treatment (usually platinum and, or, immunotherapy) has not worked or has stopped doing so, the options are limited. and do not achieve satisfactory results: the median progression-free survival (ie the time in which cancer has not recovered in 50% of patients) is approximately 4 months.
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CodeBreaK100 was conducted on 174 patients who received sotorasib after previous therapies. Well, 40.7% of patients reacted to the new drug with a complete or partial tumor shrinkage. The disease control rate, also considering the patients in whom the tumor remained stable (therefore without progression), was 83.7%: 5 patients achieved a complete response and 65 patients a partial response. The median duration of response was 12.3 months. The median progression-free survival of the disease was 6.3 months and, finally, the median overall survival of 12.5 months, with 32.5% of the affected patients still alive after two years.
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“The 2-year results of the CodeBreaK 100 study are encouraging because they confirm the role of sotorasib as the first drug to target a mutation hitherto treated with chemotherapy and / or immunotherapy in advanced stage mutated KRASG12C non-small cell lung cancer.” commented Marcello Tiseo, associate of Oncology, and head of the PDTA Diagnostic Therapeutic Assistance Pathways of Thoracic Oncology of the University Hospital of Parma. “The response rate of around 40% – added Tiseo – is definitely higher than the 10% that we used to get with chemotherapy. The two-year survival of 32.5% is also an advantage over what we previously achieved and indicates a possibility of disease control even in the longer term. Another aspect to be valued is that, being sotorasib an oral drug, it offers better tolerability than the chemotherapy treatments we had available, a fact also confirmed by the recently presented update. Sotorasib – he concludes – is becoming the first new selectively active drug in the presence of the KRASG12C mutation, capable of modifying the therapeutic scenario for this subgroup of patients, which constitutes about 12% of the total number of patients with NSCLC “.