ActiveCancerNIHR-supported projectDigestion, Kidneys & Other Organs
A Randomized, Double-Blind, Phase 3 Trial of Adagrasib plus Pembrolizumab plus Chemotherapy vs. Placebo plus Pembrolizumab plus Chemotherapy in Participants with Previously Untreated, Locally Advanced or Metastatic Non-squamous Non-small Cell Lung Cancer with KRAS G12C Mutation (KRYSTAL-4)
Recipient organisationNIHR University College London Hospitals Biomedical Research Centre
NIHR supportRecorded as supported by this research centre
PeriodJan 2025 — Apr 2032
In plain English
AI plain-English summary
A new clinical trial will test whether adding the targeted drug adagrasib to standard immunotherapy and chemotherapy can stop lung cancer from progressing in patients whose tumours carry a specific genetic mutation. Around 630 patients worldwide with previously untreated, advanced non-squamous non-small cell lung cancer and a KRAS G12C mutation will receive either adagrasib plus pembrolizumab and chemotherapy, or a placebo plus the same immunotherapy and chemotherapy. The KRAS G12C mutation drives uncontrolled cancer cell growth, and while adagrasib is already approved for later-stage use, it has not been tested as a first-line treatment alongside immunotherapy. The trial will measure how long the cancer stays under control and track side effects. If adagrasib improves outcomes in this combination, it could become a new standard first-line therapy for this specific lung cancer subtype. That would give patients with a KRAS G12C mutation a more effective treatment option from the start, potentially delaying disease progression and extending survival. The study will follow participants for up to seven years to assess long-term benefits and risks.
View original technical description
Study CA2390004 (KRYSTAL-4) is a global study of a new cancer therapy called adagrasib (BMS-986503). The study will compare two treatments: (1) adagrasib together with pembrolizumab and chemotherapy (Arm A) vs (2) a placebo together with pembrolizumab and chemotherapy (Arm B) in participants with previously untreated non-small cell lung cancer (NSCLC) that has spread to another part of the body (metastatic). Pembrolizumab is an immunotherapy drug approved for the treatment of patients with metastatic lung cancer. Adagrasib is approved for the treatment of patients with metastatic NSCLC that have a KRAS G12C mutation.\n\nParticipants will be 18 years or older, have a specific type of NSCLC (non-squamous) that expresses a protein called programmed death receptor ligand-1 (PD-L1) which affects how well the body fights cancer cells, and a mutation in a gene called KRAS (KRAS G12C) which causes cancer cells to grow and divide out of control.\n\nAbout 630 participants will take part in this study world-wide, including participants in the UK.\n\nParticipants will be randomly divided into two treatment groups:\nArm A: Adagrasib + pembrolizumab + chemotherapy \nArm B: Placebo + pembrolizumab + chemotherapy \n\nThe aim of this study is to understand how well adagrasib works in preventing progression of the cancer in combination with pembrolizumab and chemotherapy (efficacy) and to understand its side effects (safety). \n\nThe study has four periods: screening, treatment, safety, and long-term follow-up. Participants will receive treatment until their cancer gets worse, they chose to leave the study, or the study doctor decides it is best for them to stop treatment. Participants will visit the study hospital to undergo tests and review their health with the study team and will be followed-up for up to 7 years from the start of treatment to monitor response to treatment and health.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know