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2

Indication details

Control Arm
Single arm
FDA Therapeutic Indication
Indicated for the treatment of adult patients with advanced non-small cell lung cancer (NSCLC) with KRAS G12C mutation and disease progression after at least one prior systemic therapy
Tumour Type
Thoracic Malignancies
Tumour Sub-type
Non-small-cell Lung Cancer
Tumour Stage
Advanced
Tumour Sub-Group
KRAS G12C
Trial Name
KRYSTAL-1
NCT Number
NCT03785249
Trial Phase
Phase I/II

Approval details

FDA Approval
FDA accelerated approval December 2022
EMA Approval
EMA (CHMP) November 2023, EC decision January 2024
Comment
On re-examination the EMA adopted a positive opinion recommending the conditional marketing authorisation.

Primary Outcome(s)

Primary Outcome(s)
ORR
Evaluated Outcome
PFS
Form(s)
Form 3

Outcome Data

PFS Control
6.5 months
ORR
42.90%
DoR
8.5 months

Adjustments

QoL Comment
Not qualified for an ESMO-MCBS credit
Toxicity Comment
>30% grade 3-4 toxicities

Score (after adjustments)

Preliminary non-curative score

3

Toxicity adjustment
1-
Non-curative score

2

Scorecard details

ESMO-MCBS version
ESMO-MCBS v1.1
Scorecard ID
367
Scorecard version
1
Issue date
19.01.2023
Last update
13.11.2023
Adagrasib KRYSTAL-1

PRELIMINARY SCORE

ORR

ADJUSTMENTS

Not qualified for an ESMO-MCBS credit
More serious and disabling adverse events observed
Adagrasib KRYSTAL-1

SCORE

Overall Survival / Disease-Free Survival / Pathological Complete Response
Overall Survival
Progression-Free Survival
Non-inferiority (Improved Quality of Life or Reduced Adverse Events) / Response Rate
2
Overall Response Rate / Duration of Response
Thoracic Malignancies
Indicated for the treatment of adult patients with advanced non-small cell lung cancer (NSCLC) with KRAS G12C mutation and disease progression after at least one prior systemic therapy
Adagrasib
Single arm

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    Legend

    Information about symbols, abbrevations and color codes

    Red = negative
    Green = positive
    Grey = neutral
    ? Grey + ? = neutral with pending data
    DFS
    Disease-Free Survival
    DoR
    Duration of Response
    EFS
    Event-Free Survival
    HR
    Hazard Ratio
    NEB
    No evaluable benefit
    NI
    Non-inferiority Study
    ORR
    Overall Response Rate
    OS
    Overall Surival
    pCR
    Pathological Complete Response/Remission
    PFS
    Progression-Free Survival
    QoL
    Quality of Life
    RFS
    Relapse-Free Survival
    RR
    Response Rate

    QoL adjustments

    Other adjustments*

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    QoL adjustments

    Red = negative / deterioration

    Green = positive / improvement

    Other adjustments*

    Red = negative / deterioration

    Green = positive / improvement

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    * Other adjustments include:

    - Long-term plateau in the survival curve
    - Long-term plateau in the PFS curve
    - Early stopping or crossover
    - Only improved PFS mature data shows no OS advantage and no improved Qol.

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