Clinical Trials Knowledge Base
Lung · NSCLC
EGFR pathway
15
From IPASS to MARIPOSA-2 — 20 years of evolution, 1st-gen TKIs to 4th-gen combinations
IPASS
gefitinib vs carboplatin+paclitaxel
In EGFR-mut subset PFS HR 0.48 (0.36-0.64); in EGFR-WT HR 2.85 (2.05-3.98); proved EGFR status is predictive
Population: East Asian never/light-smoker adenocarcinoma, clinically selected
OPTIMAL
erlotinib vs gemcitabine+carboplatin
mPFS 13.1 vs 4.6 mo, HR 0.16 (0.10-0.26); landmark for Chinese EGFR-TKI 1L
Population: Chinese advanced EGFR-mut NSCLC
EURTAC
erlotinib vs platinum doublet
mPFS 9.7 vs 5.2 mo, HR 0.37 (0.25-0.54); erlotinib 1L confirmed in Caucasian EGFR-mut
Population: European advanced EGFR-mut NSCLC
LUX-LUNG-3
afatinib vs cisplatin+pemetrexed
mPFS 11.1 vs 6.9 mo, HR 0.58 (0.43-0.78); bigger benefit in del19/L858R common mutations
Population: Advanced EGFR-mut lung adenocarcinoma, chemo-naive
LUX-LUNG-6
afatinib vs cisplatin+gemcitabine
mPFS 11.0 vs 5.6 mo, HR 0.28 (0.20-0.39); Asian afatinib 1L validation
Population: Asian EGFR-mut advanced NSCLC
ARCHER-1050
dacomitinib vs gefitinib
mPFS 14.7 vs 9.2 mo, HR 0.59 (0.47-0.74); 2nd-gen TKI improves PFS over 1st-gen
Population: EGFR-mut advanced NSCLC, no brain mets
AURA3
osimertinib vs platinum+pemetrexed
mPFS 10.1 vs 4.4 mo, HR 0.30 (0.23-0.41); established osimertinib for T790M resistance
Population: T790M+ NSCLC after 1st/2nd-gen TKI progression
FLAURA
osimertinib vs gefitinib or erlotinib
mPFS 18.9 vs 10.2 mo, HR 0.46 (0.37-0.57); OS update mOS 38.6 vs 31.8 mo HR 0.80
Population: Advanced EGFR-mut (del19/L858R) NSCLC, chemo-naive
ADAURA
osimertinib 3 yr adjuvant vs placebo
DFS HR 0.20 (0.14-0.30) in stage II-IIIA; OS HR 0.49 (0.33-0.73) in updated analysis
Population: Stage IB-IIIA completely resected EGFR-mut NSCLC
FLAURA2
osimertinib + platinum+pemetrexed vs osimertinib
mPFS 25.5 vs 16.7 mo, HR 0.62 (0.49-0.79); TKI+chemo 可作为高危选项
Population: Advanced EGFR-mut NSCLC, chemo-naive
PAPILLON
amivantamab + carbo+pem vs carbo+pem
mPFS 11.4 vs 6.7 mo, HR 0.40 (0.30-0.53); first 1L for EGFR ex20
Population: EGFR exon 20 insertion advanced NSCLC 1L
LAURA
osimertinib consolidation vs placebo
mPFS 39.1 vs 5.6 mo, HR 0.16 (0.10-0.24); redefined SoC post-CRT in EGFR-mut III
Population: Unresectable stage III EGFR-mut NSCLC post-CRT
LUMINOSITY
Telisotuzumab vedotin
Teliso-V in c-MET high EGFR-WT non-squamous NSCLC: ORR 35% — basis for Emrelis accelerated approval.
Population: c-Met overexpressing EGFR-wildtype non-squamous NSCLC, ≤2 prior lines of therapy
MARIPOSA
amivantamab + lazertinib vs osimertinib
mPFS 23.7 vs 16.6 mo, HR 0.70 (0.58-0.85); ami+laz superior to osi in PFS
Population: Advanced EGFR-mut (del19/L858R) NSCLC 1L
MARIPOSA-2
amivantamab+chemo ± lazertinib vs chemo alone
ami+chemo vs chemo PFS HR 0.48 (0.36-0.64); ami+laz+chemo HR 0.44 (0.35-0.56); established ami-based SoC after osi
Population: Post-osimertinib EGFR-mut NSCLC
ALK / ROS1 / NTRK fusions
8
From crizotinib to lorlatinib — CNS penetration ratcheting up across generations
PROFILE-1001
crizotinib 250 mg BID
ORR 72% (95% CI 58-84); mPFS 19.2 mo; mDOR 17.6 mo; 50 ROS1+ patients established crizotinib as ROS1+ NSCLC standard
Population: 50 patients with ROS1-rearranged advanced NSCLC (phase 1 expansion cohort)
PROFILE-1014
crizotinib vs pemetrexed+platinum
mPFS 10.9 vs 7.0 mo, HR 0.45 (0.35-0.60); established crizotinib 1L for ALK+
Population: ALK-positive advanced non-sq NSCLC 1L
ALEX
alectinib vs crizotinib
mPFS 34.8 vs 10.9 mo (updated), HR 0.43 (0.32-0.58); CNS progression HR 0.16
Population: ALK+ advanced NSCLC 1L
ASCEND-4
ceritinib vs platinum+pemetrexed
mPFS 16.6 vs 8.1 mo, HR 0.55 (0.42-0.73); confirmed 2nd-gen ALK TKI benefit
Population: ALK+ advanced NSCLC 1L
LAROTRECTINIB
larotrectinib vs none
ORR 75% (61-85); histology-agnostic TRK inhibitor activity
Population: NTRK fusion+ tumors across histologies incl. NSCLC
CROWN
lorlatinib vs crizotinib
mPFS NR vs 9.3 mo, HR 0.28 (0.19-0.41); intracranial response 82% vs 23%
Population: ALK+ advanced NSCLC 1L
ALINA
Alectinib vs Platinum-Based Chemotherapy
Adjuvant alectinib in resected ALK+ NSCLC: DFS HR 0.24 vs chemo.
Population: completely resected ALK+ NSCLC, stage IB (≥4 cm) / II / IIIA, adjuvant setting
TRIDENT-1
repotrectinib vs none
TKI-naive ORR 79% (68-88), mPFS 35.7 mo; TKI-pretreated ORR 38%; next-gen ROS1 covering G2032R
Population: ROS1+ NSCLC TKI-naive and pre-treated
KRAS G12C
3
A hard-to-drug target cracked after 40 years: sotorasib / adagrasib now in clinic
KRYSTAL-1
adagrasib vs none
ORR 42.9% (33.5-52.6); mPFS 6.5 mo; CNS penetration better than sotorasib
Population: KRAS G12C pre-treated NSCLC
CODEBREAK-200
sotorasib vs docetaxel
mPFS 5.6 vs 4.5 mo, HR 0.66 (0.51-0.86); OS neutral; confirmatory RCT
Population: KRAS G12C NSCLC post-platinum+IO
KRYSTAL-12
MRTX849 vs Docetaxel
Adagrasib vs docetaxel KRAS G12C NSCLC: mPFS 5.5 vs 3.8 mo, HR 0.58.
Population: KRAS G12C-mutant advanced NSCLC, previously treated with platinum chemo and anti-PD-(L)1
Rare drivers (BRAF / MET / RET / HER2)
9
The long tail of precision oncology — small populations, strong signals, phase II series
DABRAFENIB+TRAMETINIB-BRF113928
dabrafenib+trametinib vs none
ORR 63.2% (49.3-75.6); mPFS 9.7 mo; established BRAF+MEK combo in NSCLC
Population: BRAF V600E pre-treated NSCLC
LIBRETTO-001
selpercatinib vs none
Pretreated ORR 64% (54-73); tx-naive ORR 85%; mDOR 17.5 mo
Population: RET fusion+ NSCLC
VISION
tepotinib vs none
ORR 46% by liquid biopsy, 48% by tissue; mDOR ~11 mo; first MET-selective approval evidence
Population: MET exon 14 skipping NSCLC
ARROW
pralsetinib vs none
Pretreated ORR 61% (50-71); tx-naive ORR 70%; another RET-selective TKI
Population: RET fusion+ NSCLC
DESTINY-LUNG01
T-DXd 6.4 mg/kg vs none
ORR 55% (44-65); mDOR 9.3 mo; mPFS 8.2 mo; first HER2-targeted ADC efficacy in NSCLC
Population: HER2-mut pre-treated NSCLC
DESTINY-LUNG02
Trastuzumab deruxtecan 6.4 mg/kg vs Trastuzumab deruxtecan 5.4 mg/kg
Final analysis — 5.4 mg/kg preferred dose, better tolerability with similar efficacy.
Population: previously platinum-treated HER2-mutant metastatic NSCLC
LIBRETTO-431
selpercatinib vs platinum+pemetrexed ± pembrolizumab
mPFS 24.8 vs 11.2 mo, HR 0.46 (0.31-0.70); RET-TKI 1L confirmed
Population: RET fusion+ advanced NSCLC 1L
PHAROS
Treatment Period
Updated efficacy and safety of enco+bini in BRAF V600E NSCLC.
Population: BRAF V600E-mutant metastatic NSCLC (phase II, single-arm)
ZONGERTINIB
Phase Ia - Dose escalation part vs Phase Ib - Dose expansion part: Cohort 1
Oral HER2-selective TKI in HER2-mutated NSCLC: ORR 71%, mPFS 12.4 mo — FDA accelerated 2025.
Population: HER2-mutant advanced/metastatic NSCLC, previously treated (phase 1a-1b)
Immune checkpoint monotherapy
10
From 2015: pivotal evidence moving PD-1 / PD-L1 from 2L to 1L
CHECKMATE-017
nivolumab vs docetaxel
mOS 9.2 vs 6.0 mo, HR 0.59 (0.44-0.79); first PD-1 mAb approved in NSCLC
Population: Pretreated advanced squamous NSCLC
CHECKMATE-057
nivolumab vs docetaxel
mOS 12.2 vs 9.4 mo, HR 0.73 (0.59-0.89); PD-L1 enrichment signal
Population: Pretreated advanced non-sq NSCLC
KEYNOTE-010
pembrolizumab 2 or 10 mg/kg vs docetaxel
mOS pembro 2mg vs doc 10.4 vs 8.5 mo, HR 0.71 (0.58-0.88); PD-L1≥50% HR 0.54
Population: Pretreated PD-L1≥1% advanced NSCLC
KEYNOTE-024
pembrolizumab vs platinum doublet
mPFS 10.3 vs 6.0 mo, HR 0.50 (0.37-0.68); mOS 30.0 vs 14.2 mo
Population: PD-L1≥50% advanced NSCLC, chemo-naive
POPLAR
atezolizumab vs docetaxel
mOS 12.6 vs 9.7 mo, HR 0.73 (0.53-0.99); dose-response with PD-L1
Population: Pretreated advanced NSCLC
PACIFIC
durvalumab consolidation vs placebo
mPFS 16.8 vs 5.6 mo HR 0.52 (0.42-0.65); mOS 47.5 vs 29.1 mo HR 0.72
Population: Unresectable stage III NSCLC post-CRT
CHECKMATE-227
nivolumab + ipilimumab vs platinum doublet (PD-L1≥1%) or nivo/chemo (PD-L1<1%)
PD-L1≥1% mOS 17.1 vs 14.9 mo, HR 0.79 (0.67-0.94); dual-IO chemo-free option
Population: 1L advanced NSCLC all PD-L1
KEYNOTE-042
pembrolizumab vs platinum doublet
TPS≥50% mOS 20.0 vs 12.2 mo HR 0.69 (0.56-0.85); benefit driven by high expressors
Population: PD-L1≥1% advanced NSCLC 1L
IMPOWER110
atezolizumab vs platinum doublet
TC3/IC3: mOS 20.2 vs 13.1 mo, HR 0.59 (0.40-0.89); atezolizumab 1L PD-L1-high
Population: PD-L1-high advanced NSCLC 1L
MYSTIC
durvalumab ± tremelimumab vs chemo
OS not significant (HR 0.76 not meeting threshold); bTMB signal; failed 1L IO-IO
Population: 1L metastatic NSCLC
IO + chemotherapy
12
Post-KEYNOTE-189 standard 1L for non-sq NSCLC — US and Chinese regimens compete
IMPOWER150
atezolizumab + bevacizumab + carbo + paclitaxel vs bev + carbo + paclitaxel
ABCP vs BCP PFS HR 0.62 (0.52-0.74); mOS 19.2 vs 14.7 mo HR 0.78 (0.64-0.96)
Population: 1L non-sq NSCLC incl. EGFR/ALK after TKI failure
KEYNOTE-189
pembrolizumab + pemetrexed + platinum vs placebo + pemetrexed + platinum
OS HR 0.49 (0.38-0.64); mOS 22.0 vs 10.7 mo; SoC for EGFR/ALK-WT 1L non-sq
Population: 1L advanced non-sq NSCLC without EGFR/ALK alterations
KEYNOTE-407
pembrolizumab + carbo + (nab-)paclitaxel vs placebo + carbo + (nab-)paclitaxel
mOS 15.9 vs 11.3 mo, HR 0.64 (0.49-0.85); SoC for 1L squamous NSCLC
Population: 1L advanced squamous NSCLC
IMPOWER130
atezo + carbo + nab-paclitaxel vs carbo + nab-paclitaxel
mOS 18.6 vs 13.9 mo, HR 0.79 (0.64-0.98); 1L non-sq IO-chemo option
Population: 1L non-sq NSCLC, EGFR/ALK-WT ITT
ORIENT-11
sintilimab + pemetrexed + platinum vs placebo + pemetrexed + platinum
mPFS 8.9 vs 5.0 mo, HR 0.482 (0.362-0.643); Chinese-developed PD-1 1L data
Population: Chinese 1L non-sq NSCLC EGFR/ALK-WT
CAMEL
camrelizumab + carbo + pem vs carbo + pem
mPFS 11.3 vs 8.3 mo, HR 0.60 (0.45-0.79); camrelizumab 1L non-sq
Population: Chinese 1L non-sq NSCLC
CHECKMATE-9LA
nivo + ipi + 2 cycles chemo vs 4 cycles chemo
mOS 15.6 vs 10.9 mo, HR 0.66 (0.55-0.80); limited-course chemo + dual IO
Population: 1L advanced NSCLC
IMPOWER132
atezolizumab + carbo/cis + pemetrexed vs carbo/cis + pemetrexed
PFS HR 0.60 (0.49-0.72); OS HR 0.86 (0.71-1.06) NS; positive PFS, negative OS
Population: 1L non-sq NSCLC EGFR/ALK-WT
ORIENT-12
sintilimab + gemcitabine + platinum vs placebo + gem + platinum
mPFS 5.5 vs 4.9 mo, HR 0.536 (0.422-0.681); sintilimab 1L sq
Population: Chinese 1L sq NSCLC
RATIONALE-304
tislelizumab + pem + platinum vs pem + platinum
mPFS 9.7 vs 7.6 mo, HR 0.645 (0.462-0.902); tislelizumab 1L non-sq
Population: Chinese 1L non-sq NSCLC
RATIONALE-307
tislelizumab + paclitaxel/nab-pac + carbo vs paclitaxel + carbo
mPFS 7.6 vs 5.5 mo, HR 0.524 (0.370-0.742); tislelizumab 1L sq
Population: Chinese 1L sq NSCLC
POSEIDON
durvalumab ± tremelimumab + chemo vs chemo
durva+treme+chemo vs chemo mOS 14.0 vs 11.7 mo HR 0.77 (0.65-0.92); durva+chemo OS HR 0.86
Population: 1L metastatic NSCLC
Perioperative IO (neoadjuvant / adjuvant)
9
The third front for resectable NSCLC: CheckMate-816 / KEYNOTE-671 / AEGEAN
NADIM
neoadjuvant nivo + paclitaxel + carbo vs none
MPR 83%, pCR 63% in resected; 24-mo PFS 77.1%; generator hypothesis signal
Population: Resectable stage IIIA NSCLC
IMPOWER010
atezolizumab adjuvant vs best supportive care
In PD-L1≥1% stage II-IIIA DFS HR 0.66 (0.50-0.88); first adjuvant IO signal
Population: Resected stage IB-IIIA NSCLC post adjuvant chemo
CHECKMATE-816
neoadjuvant nivo + chemo (3 cycles) vs neoadjuvant chemo
pCR 24.0% vs 2.2%; EFS HR 0.63 (0.43-0.91); first phase III neoadj IO for NSCLC
Population: Resectable stage IB-IIIA NSCLC
KEYNOTE-091
pembrolizumab adjuvant vs placebo
Overall DFS HR 0.76 (0.63-0.91); PD-L1≥50% DFS HR 0.82 (NS); positive overall population
Population: Resected stage IB-IIIA NSCLC post adjuvant chemo
AEGEAN
neoadj durva+chemo → surgery → adjuvant durva vs neoadj chemo → placebo
EFS HR 0.68 (0.53-0.88); pCR 17.2% vs 4.3%; durva perioperative benefit
Population: Resectable stage II-IIIB NSCLC
KEYNOTE-671
neoadj pembro+chemo → surgery → adjuvant pembro vs neoadj chemo → surgery → placebo
EFS HR 0.58 (0.46-0.72); mOS HR 0.72 (0.56-0.93); perioperative pembro significantly improves OS
Population: Resectable stage II-IIIB NSCLC
CHECKMATE-77T
neoadj nivo+chemo → adjuvant nivo vs neoadj chemo → placebo
EFS HR 0.58 (0.42-0.81); pCR 25.3% vs 4.7%; nivo perioperative confirmed
Population: Resectable stage IIA-IIIB NSCLC
NEOTORCH
neoadj toripalimab+chemo → adjuvant toripalimab vs chemo
EFS HR 0.40 (0.28-0.57); MPR 48.5% vs 8.4%; Chinese PD-1 perioperative success
Population: Chinese resectable stage II-III NSCLC
RATIONALE-315
neoadj tislelizumab+chemo → adjuvant tislelizumab vs neoadj chemo → placebo
MPR 56.2% vs 15.0%; EFS HR 0.56 (0.40-0.79); tislelizumab perioperative
Population: Chinese resectable stage II-IIIA NSCLC
Chemotherapy (historical)
5
Landmark trials from the pre-IO chemo era — still today's control-arm reference
ECOG-1594
cisplatin+paclitaxel vs cisplatin+gemcitabine vs cisplatin+docetaxel vs cisplatin+paclitaxel (reference)
No platinum doublet superior to another; mOS ~7.9 mo, 1-yr OS 33%; established 'no best regimen' plateau for unselected NSCLC
Population: Stage IIIB/IV advanced NSCLC, chemo-naive
TAX-326
docetaxel+cisplatin or docetaxel+carboplatin vs vinorelbine+cisplatin
DC vs VC: mOS 11.3 vs 10.1 mo, HR 1.183 (95% CI not explicitly in abstract); established docetaxel doublet as alternative 1L standard
Population: Stage IIIB/IV chemo-naive NSCLC
ECOG-4599
paclitaxel+carboplatin+bevacizumab vs paclitaxel+carboplatin
mOS 12.3 vs 10.3 mo, HR 0.79 (0.67-0.92); first biologic on doublet in 1L non-sq NSCLC
Population: Advanced non-squamous NSCLC, no brain mets, no hemoptysis
PARAMOUNT
pemetrexed continuation maintenance vs placebo
PFS HR 0.62 (0.49-0.79); established continuation maintenance of pemetrexed post cis+pem induction
Population: Non-sq NSCLC, non-progressing after 4 cycles cis+pem induction
TROPION-LUNG01
DS-1062a 6.0 mg/kg vs Docetaxel 75 mg/m^2
Dato-DXd vs docetaxel in previously treated NSCLC: PFS HR 0.75; EGFR-mutated subgroup HR 0.38.