The international KROCUS study, authored by. Dr. Vanesa Gregorc, oncologist and Director of the Division of Clinical Research and Innovation at INOC – Istituto Nazionale Oncologico Candiolo, paves the way for chemo-free therapy to treat non-small cell lung cancer, achieving disease regression in about 80% of cases.

The incidence of lung cancer in Italy.

Today, lung cancer is the third most common type of cancer in Italy, with about 45,000 new diagnoses each year. For those battling the most common form of this disease (accounting for 85 percent of cases), important news comes from the international KROCUS study itself, which bears the first signature of Dr. Vanesa Gregorc.

According to the study, the combination of two biologic drugs (fulzerasib and cetuximab) used as the first therapy is able to regress the tumor in 80 percent of cases, recording an average progression-free survival of 12.5 months, with many patients still on treatment years later. This remarkable result is achieved without the need for chemotherapy, providing patients with a more targeted and better tolerated treatment.

A successful challenge against tumor resistance

Among patients with non-small cell lung cancer (NSCLC), about 13% have the KRAS G12C mutation, which for decades was considered an impossible target for drugs. “Although the new inhibitors have begun to show inhibitory effects on disease, resistance given by cancer cells remains a challenge: they can ‘reactivate’ themselves by bypassing drug blockade. With this study, we have shown that concomitant inhibition with two drugs can overcome resistance mechanisms as already shown in preclinical studies at INOC,” explains Dr. Gregorc.

Quality of life and future prospects

In addition to its efficacy in regressing the disease, a key aspect of this new therapy is its high tolerability. Unlike other drugs in the same category, fulzerasib does not cause the severe liver or intestinal toxicities that often force patients to discontinue or reduce treatment. Side effects are limited to manageable skin reactions, allowing the patient to continue treatment with greater peace of mind.

Because of these extremely encouraging results, the research is not stopping. In fact, a larger clinical trial, called Phase 3, is already being designed that will directly compare this biologic combination with the current standard of care (chemo and immunotherapy). The goal is to permanently change the treatment algorithm for this disease, making this targeted approach the main choice for treating patients.