Krascendo 3: A randomised, phase III trial in progress of divarasib vs immunotherapy or observation in patients with resected, stage II-IIIB, KRAS G12C+ non-small cell lung cancer
https://esmocongress.esmo.org
ESMO 2026
2026 年 10 月 23–27 日 · Madrid · 共 2840 条
#NSCLC
6 人 · 6 条 · 8 篇摘要
本事件热度走势
当前热度 1·可比范围峰值 2(10月24日 04:00)·近 24 小时可比范围变化 –·当前参与者 3
在无可作用基因组改变(AGA阴性)的晚期非小细胞肺癌(NSCLC)中,以免疫检查点抑制为基础的系统治疗已经由III期证据坐镇一线:PD-L1≥50%且无EGFR敏感突变或ALK易位的患者中,帕博利珠单抗单药对比研究者选择的含铂化疗,中位PFS为10.3对6.0个月[2];无敏感EGFR/ALK突变的转移性非鳞患者中,帕博利珠单抗加入化疗此前已在II期试验中显著提高缓解率并延长PFS,随后在616例的双盲III期中以OS和PFS为主要终点做了检验[6];经治的非鳞与鳞状患者中,纳武利尤单抗对比多西他赛也分别把中位OS提高到12.2对9.4个月[3]和9.2对6.0个月[5]。而EGFR突变与吉非替尼疗效相关的发现[4]让驱动基因阳性人群走上另一条治疗路径,这正解释了SARON为何把入组限定在AGA阴性——它要回答的是在免疫为基础的系统治疗之上,巩固放疗还能不能再加分。
本届ESMO26(马德里)现场另有几条日程性消息:Passaro医生与同行共同主持了一场聚焦NSCLC未来的专题研讨会,@Lung_Cancers预告了与@LeXiuning的访谈;但真正的新数据读数是随机II期SARON试验(报告人@fifimcdrmh)。该研究纳入同步寡转移、AGA阴性的NSCLC患者(n=140),在一线系统治疗基础上加用巩固放疗:中位PFS为13.9对8.9个月,HR 0.64,p=0.03;12个月局部失败率13.0%对39.5%,p<0.01;但中位OS为31.0对28.0个月,HR 0.99,p=0.95;≥3级不良事件两臂均为28.6%。
这一读数的推进之处在于把局部控制与生存获益拆开来看:巩固放疗明确改善了疾病控制,把12个月局部失败率从39.5%压到13.0%,PFS延长且有统计学意义,却完全没有换来OS上的差异(HR 0.99)。发帖解读的肿瘤医生据此强调,寡转移不是一个单一的生物学状态,局部治疗的价值可能取决于患者选择、疾病生物学、时机,以及控制可见病灶能否真正改变疾病的系统病程。≥3级毒性在两臂完全相同,也提示安全性负担主要来自一线系统治疗,而非放疗的叠加。
局限同样清晰:这是II期、n=140的试验,OS未显示差异;放疗的具体方案、随访时长、局部失败的定义等细节在会议帖中未披露,结果能否外推到AGA阳性或其他寡转移情境也有待确认。
- 1.Cancer Statistics, 2021 · CA Cancer J Clin 2021
- 2.Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer · N Engl J Med 2016
- 3.Nivolumab versus Docetaxel in Advanced Nonsquamous Non-Small-Cell Lung Cancer · N Engl J Med 2015
- 4.EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy · Science 2004
- 5.Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer · N Engl J Med 2015
- 6.Pembrolizumab plus Chemotherapy in Metastatic Non-Small-Cell Lung Cancer · N Engl J Med 2018
First-line BAT8008 (TROP2-ADC) plus BAT1308 (anti-PD-1) for advanced NSCLC: Results from a multicenter phase 2 study
https://esmocongress.esmo.orgCharacterizing resistance mechanisms and predictors of early progression and long-term response to lorlatinib: Circulating tumor DNA (ctDNA) analyses from the CROWN study
https://esmocongress.esmo.orgOverall survival (OS) analysis of telisotuzumab adizutecan in patients (pts) with nonsquamous non-small cell lung cancer (NSQ NSCLC): Phase 1 first-in-human study
https://esmocongress.esmo.orgPhase 2 trial of the PD-1/VEGF bispecific antibody, PF-08634404 (SSGJ-707), plus chemotherapy (chemo) in advanced NSCLC: Updated results
https://esmocongress.esmo.orgFirst-line (1L) olomorasib + pembrolizumab in KRAS G12C-mutant NSCLC: Updated results from LOXO-RAS-20001 and SUNRAY-01
https://esmocongress.esmo.orgImproving prevention of moderate to severe dermatologic adverse events in EGFR-mutant advanced NSCLC treated with first-line (1L) subcutaneous (SC) amivantamab + lazertinib: First results from a new COCOON cohort
https://esmocongress.esmo.orgFLAURA2: Analysis of on-treatment plasma EGFRm dynamics and associated clinical outcomes in patients (pts) with EGFRm advanced NSCLC treated with first-line (1L) osimertinib (osi) ± platinum–pemetrexed (plat–pem)
https://esmocongress.esmo.orgRoberto Borea, MD@RobertoBoreaMD LUNGevity Foundation@LUNGevity Yale Cancer Center@YaleCancer Aɴᴛᴏɴɪᴏ Pᴀssᴀʀᴏ@APassaroMD LUNGevity Foundation@LUNGevity Dra. María Natalia Gandur Quiroga@nataliagandur 引用@OncoAlert 4Sight Abstracts to be Presented at #ESMO26 Primary Results of SARON: A Randomised-Controlled Trial of Consolidation Radiotherapy for Synchronous Oligometastatic Non-Small Cell Lung Cancer @fifimcdrmh 🫁 Randomized phase II (n=140): first-line SACT ± consolidation radiotherapy in synchronous oligometastatic AGA-negative NSCLC. Endpoints: OS and PFS. ➡️ Median OS 31.0 vs 28.0 mo; HR 0.99 (0.63–1.55); p=0.95 ➡️ Median PFS 13.9 vs 8.9 mo; HR 0.64 (0.43–0.95); p=0.03 ➡️ 12-month local failure 13.0% vs 39.5% (p<0.01); grade ≥3 AEs 28.6% in both arms ✅ SACT + RT achieved better local disease control and longer PFS with acceptable side effects, but this did not translate into survival benefit. 🎙️ Fiona McDonald (4Sight Made from Abstracts publicly available at the ESMO website) Pinging our OncoAlert Lung Cancer Faculty @christine_lovly, @GlopesMd, @DrSanjayPopat, @StephenVLiu, @jillfeldman4, @UOzkerim, @DrMirallas, @MartinReck2 , @bmassutis @UmbertoMalapel1 , @CharuAggarwalMD @peters_solange, @HenningWillers, @HHorinouchi, @BRicciutiMD, @PercyLeeMD, @bensolomon1, @Latinamd, @DrJNaidoo, @barlesi, @VanitaNoronha, @ChristianRolfo @Tony_Calles @s_couraud @marinagarassino @g_mountzios @BairdAM @barlesi @JFreemanDaily @Piuchagarrido @PercyLeeMD @bensolomon1 @VanitaNoronha @alexdrilon @JordiRemon @JulienMazieres @TerriConneran @HenningWillers
Young Kwang Chae, MD, MPH, MBA@youngkwangchae Yale Cancer Center@YaleCancer Roberto Borea, MD@RobertoBoreaMD AACR 2026 现场信号@ AACR 2026 现场信号@ Lung Cancers Today@Lung_Cancers MedChemExpress-US@MCE_US 引用@🔬ESMO 2026 Lung Cancer Abstract Highlights | How are emerging therapies reshaping the lung cancer treatment landscape? These 10 selected phase III studies explore new strategies across #SCLC and #NSCLC, including immunotherapy, next-generation #ADCs and targeted approaches to treatment resistance. 🔹DeLLphi-305 (LBA3): Tarlatamab + durvalumab vs. durvalumab alone as first-line maintenance for ES-SCLC, testing DLL3-directed T-cell engagement earlier in treatment. 🔹OptiTROP-Lung06 (LBA66): Sacituzumab tirumotecan (TROP2 ADC) + pembrolizumab vs. chemotherapy + pembrolizumab in first-line PD-L1-negative advanced nonsquamous NSCLC. 🔹OptiTROP-Lung04 (LBA67): Final overall survival analysis of sacituzumab tirumotecan vs. platinum-based chemotherapy after EGFR-TKI progression in EGFR-mutated NSCLC. 🔹Sigvotatug Vedotin (LBA68): A phase III comparison with docetaxel in previously treated nonsquamous NSCLC, examining efficacy and safety. 🔹KRASCENDO 1 (LBA5): Divarasib vs. sotorasib or adagrasib in previously treated KRAS G12C-mutated NSCLC, offering a direct comparison within the targeted therapy class. 🔹SAFFRON (LBA6): Osimertinib + savolitinib vs. platinum-pemetrexed after osimertinib progression in EGFR-mutated NSCLC with MET overexpression and/or amplification. 🔹SANOVO (LBA69): Savolitinib + osimertinib vs. osimertinib alone in treatment-naïve EGFR-mutated NSCLC with MET overexpression, exploring upfront dual-target inhibition. 🔹PANKU-Lung01 (LBA71): Izalontamab brengitecan, a bispecific ADC, in EGFR-mutated nonsquamous NSCLC after progression on a third-generation EGFR-TKI. 🔹HERON-Lung01 (LBA72): Ruzaltatug rezetecan, a HER3-directed ADC, vs. platinum-based chemotherapy after EGFR-TKI progression in EGFR-mutated advanced NSCLC. 🔹Neotorch (LBA64): Final analysis of perioperative toripalimab + chemotherapy in resectable stage II-III NSCLC, focusing on long-term outcomes. 🔗Read more: https://oncodaily.com/oncolibrary/lung-oncology/esmo-2026-lung 💡MedChemExpress offers 3900+ tools for lung cancer research: https://www.medchemexpress.com/disease-areas/lung-cancer.html #ESMO26 #ESMO2026 #ESMO #LungCancer #CancerResearch #Oncology
Raffaele Di Giacomo, PhD@sciqst LUNGevity Foundation@LUNGevity Yvonne Diaz@Yvonne_Diaz_ Science At BMS@ScienceAtBMS LUNGevity Foundation@LUNGevity