KRAScendo-1 results presented at ESMO favour divarasib over sotorasib or adagrasib for overall survival in previously treated advanced lung cancer with a KRAS G12C alteration. Time before disease progression also favoured divarasib. The patients had a defined tumour alteration and had already received treatment. First-line benefit remains untested here. Divarasib remains investigational, and adverse effects remain part of the clinical assessment.
KRAScendo-1 compared divarasib with sotorasib or adagrasib in advanced lung cancer after previous systemic treatment. The phase 3 trial enrolled patients whose tumours carried the KRAS G12C alteration. Results presented in Madrid favoured divarasib for both overall survival and time before disease progression. Other forms of lung cancer and other KRAS alterations were outside this defined group.[1], [2]
Investigators separately assessed tumour response and its duration. Tumour shrinkage, delayed progression and longer lifespan are distinct outcomes. The detailed congress presentation also identified the comparator drugs and patient group behind an earlier positive topline announcement. It did not prove the same advantage when the medicine is used first, before other systemic treatments; that is a separate research question.[1]
Diarrhoea, nausea and vomiting were more frequent with divarasib. Most were mild, while serious adverse effects were also tracked. Treatment-related discontinuation was reported more often under the comparator approach. The groups spent different lengths of time on treatment, a relevant factor when reading safety figures. Divarasib remains investigational. A clinical presentation is distinct from a regulator’s decision on where and for whom the drug may be used.[1]
