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Phase III: Divarasib and pembrolizumab in NSCLC (Krascendo 2)

Clinical Trial Overview

A Phase III, Randomized, Open-Label Study Evaluating the Efficacy and Safety of Divarasib and Pembrolizumab Versus Pembrolizumab and Pemetrexed and Carboplatin or Cisplatin in Patients With Previously Untreated, KRAS G12C-Mutated, Advanced or Metastatic Non-Squamous Non-Small Cell Lung Cancer

Objective

The purpose of this study is to evaluate the efficacy and safety of divarasib and pembrolizumab compared with pembrolizumab and pemetrexed and carboplatin or cisplatin, for the first-line treatment of adult participants with KRAS G12C-mutated, advanced or metastatic non squamous non-small cell lung cancer (NSCLC)

Primary Endpoints

  • Progression-Free Survival (PFS), PFS is defined as the time from randomization to the first occurrence of disease progression, as determined by blinded independent central review (BICR) according to RECIST v1.1, or death from any cause (whichever occurs first)
  • Overall Survival (OS), OS is defined as the time from randomization to death from any cause

Secondary Endpoints

  • Objective Response,Objective response is defined as complete response (CR) or partial response (PR) on two consecutive occasions >=4 weeks apart, as determined by BICR according to RECIST v1.1, Up to approximately 5 years
  • Change from Baseline on the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Supplemental Lung Cancer Module (EORTC QLQ-LC13) Cough Scale, Baseline up to Cycle 5 Day 1 (each cycle is 21 days)
  • Change from Baseline on the EORTC Quality of Life Questionnaire (QLQ-C30) Dyspnea Item and Physical Functioning Scale, Baseline up to Cycle 5 Day 1 (each cycle is 21 days)
  • Duration of Response (DOR), DOR is defined as the time from the first occurrence of a documented objective response to disease progression, as determined by BICR according to RECIST v1.1, or death from any cause (whichever occurs first), Up to approximately 5 years
  • Percentage of Participants with Adverse Events (AEs), Up to approximately 5 years
  • Number of Participants Reporting Presence, Frequency, Severity, and/or Degree of Interference with Daily Function of Symptomatic Treatment Toxicities Assessed by NCI Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE), Up to approximately 5 years
  • Change from Baseline in the Severity of Selected Symptomatic Treatment Toxicities as Assessed Through use of the NCI PRO-CTCAE, Up to approximately 5 years
  • Frequency of Participants' Response of the Degree they are Troubled with Treatment Symptoms, as Assessed Through use of the single-item EORTC Item List (IL46), Up to approximately 5 years
  • Change from Baseline on the EORTC QLQ-C30 and QLQ-LC13 Functional and Global Health Status Score/Quality of Life Score (GHS/QoL), Up to approximately 5 years

PFS=Progression-Free Survival; BICR=blinded independent central review; RECIST v1.1=Response Evaluation Criteria in Solid Tumors version 1.1; OS=Overall Survival; CR=complete response; PR=partial response; EORTC QLQ-LC13=European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Supplemental Lung Cancer Module; EORTC QLQ-C30=European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Dyspnea Item and Physical Functioning Scale; DOR=Duration of Response; AEs=Adverse Events.NCI PRO-CTCAE=Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events.

Inclusion and Exclusion Criteria

Key Inclusion Criteria Key Exclusion Criteria
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Histologically or cytologically confirmed diagnosis of advanced or metastatic non squamous NSCLC that is not eligible for curative surgery and/or definitive chemoradiotherapy
  • Measurable disease, as defined by RECIST v1.1
  • No prior systemic treatment for advanced or metastatic NSCLC
  • Documentation of the presence of a KRAS G12C mutation
  • Documentation of known PD-L1 expression status in tumor tissue
  • Availability of a representative tumor specimen
  • Adequate end-organ function
  • Eligible to receive a platinum-based chemotherapy regimen

Exclusion Criteria Related to NSCLC:

  • Known concomitant second oncogenic driver with available targeted treatment
  • Symptomatic, untreated, or actively progressing central nervous system (CNS) metastases
  • Spinal cord compression not definitively treated with surgery and/or radiation or previously diagnosed and treated spinal cord compression without evidence that disease has been clinically stable for >=2 weeks prior to randomization
  • History of leptomeningeal disease
  • Uncontrolled tumor-related pain
  • Uncontrolled pleural effusion, pericardial effusion, or ascites requiring recurrent drainage procedures (once a month or more frequently)

Exclusion Criteria Related to Current or Prior Treatments:

  • Any anti-cancer systemic therapy, including hormonal therapy, within 21 days prior to randomization, or is expected to require any other form of antineoplastic therapy while in the study
  • Radiation therapy including palliative RT to bone metastases within 2 weeks prior to randomization and RT to the lung >30Gy within 6 months prior to randomization
  • Prior treatment with KRAS G12C inhibitors or pan-KRAS/RAS inhibitors
  • Treatment with systemic immunosuppressive or immunostimulatory medications, including CD137 agonists and immune checkpoint inhibitors
  • Current treatment with medications that are well known to prolong the QT interval
  • Treatment with therapeutic oral or IV antibiotics within 2 weeks prior to randomization
  • Prior allogeneic stem cell or solid organ transplantation

Exclusion Criteria Related to General Health:

  • History of malignancy other than NSCLC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death (e.g., 5-year overall survival [OS] rate >90%), such as adequately treated carcinoma in situ of the cervix, non melanoma skin carcinoma, localized prostate cancer, ductal breast carcinoma in situ, or Stage I uterine cancer
  • Individuals with chronic diarrhea, short bowel syndrome or significant upper gastrointestinal surgery including gastric resection, a history of inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis) or any active bowel inflammation (including diverticulitis), malabsorption syndrome, conditions that would interfere with enteral absorption
  • History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis obliterans), drug-induced pneumonitis, or idiopathic pneumonitis, or evidence of active pneumonitis on the screening chest computed tomography scan
  • Significant cardiovascular disease within 3 months prior to screening

ECOG=Eastern Cooperative Oncology Group; NSCLC=non squamous non-small cell lung cancer; RECIST v1.1=Response Evaluation Criteria in Solid Tumors version 1.1; KRAS G12C=Kirsten rat sarcoma viral oncogene homolog G12C; PD-L1=Programmed death-ligand 1; CNS=central nervous system; RT=Radiation therapy; NSCLC=non-small cell lung cancer; OS=Overall Survival; CD137=Cluster of Differentiation 137; RAS=RAt Sarcoma

Enrollment & Resources

Enrollment

For more information on eligibility criteria, view the study or reach out to our team.

General icon

Web

ClinicalTrials.gov
Identifier: NCT06793215

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Phone

1-888-662-6728
(US and Canada)

Clinical Trial Site Locations

Clinical Trial Site Locations

For more information on recruitment status, or where the study is being conducted

Information is consistent with ClinicalTrials.gov as of January 18, 2026. Products under investigation have not been approved for use outside of the clinical trial setting. This information is presented only for the purposes of providing an overview of clinical trials and should not be construed as a recommendation for use of any product for unapproved purposes.

Looking for more information?

Reach out to a Genentech Medical Science Liaison near you, or connect with the contact center.

Call the Trial Information Support Team: 1-888-662-6728 Hours: Monday-Friday, 5am-5pm PT

  • AEs
    Adverse Events

  • BICR
    blinded independent central review

  • CD137
    Cluster of Differentiation 137

  • CNS
    central nervous system

  • CR
    complete response

  • DOR
    Duration of Response

  • ECOG
    Eastern Cooperative Oncology Group

  • EORTC QLQ-C30
    European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30)

  • EORTC QLQ-LC13
    European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Supplemental Lung Cancer Module

  • IV
    Intravenous

  • KRAS G12C
    Kirsten rat sarcoma viral oncogene homolog G12C

  • NSCLC
    non-small cell lung cancer

  • OS
    Overall Survival

  • PD-L1
    Programmed death-ligand 1

  • PR
    partial response

  • RAS
    RAt Sarcoma

  • RT
    Radiation therapy