EMPOWER-Lung 1 Outcomes in KRAS G12C NSCLC

Rajwanth R. Veluswamy, MD, MSCR, of the Perlmutter Cancer Center at NYU Langone Health, and Chinmay Jani, MD, of the University of Miami Sylvester Comprehensive Cancer Center, review first-line immunotherapy outcomes in KRAS G12C-mutated non-small cell lung cancer. They discuss EMPOWER-Lung 1, a phase 3 trial of first-line cemiplimab versus platinum-based chemotherapy in patients with programmed death-ligand 1 expression of 50% or higher and no EGFR, ALK, or ROS1 alteration; never smokers were excluded. Dr. Veluswamy reports that among 89 trial patients with a KRAS mutation, cemiplimab produced a response rate above 67%, a median progression-free survival of 18.9 months, and a median overall survival of 53 months, with the KRAS G12C subgroup reaching a 74% response rate and 25-month progression-free survival. Dr. Jani notes that KRAS-positive patients fared worse on chemotherapy alone, underscoring immunotherapy's benefit; he cautions, however, that the analysis was exploratory and that the trial's smoker-skewed population and PD-L1 threshold limit how broadly the findings apply.