A next-generation KRAS pill beat older ones and helped people with lung cancer live longer
Lung cancerPart of a story we are following · 9 articles · See every update
Divarasib, a new KRAS G12C pill, extended median survival to 17.7 months vs. 12.0 months with sotorasib or adagrasib in previously treated lung cancer, with fewer serious side effects, in a phase 3 trial published Oct. 25, 2026, in New England Journal of Medicine. It sets a new bar for this lung cancer mutation.
Some lung cancers of the most common type carry a mutation called KRAS G12C. For decades, KRAS was considered impossible to target, until pills like sotorasib and adagrasib arrived.
Divarasib kept the cancer in check longer and helped people live longer.
What did the trial test?
338 people with previously treated advanced non-small cell lung cancer with the KRAS G12C mutation were assigned by chance to divarasib once a day or to one of the first-generation pills, sotorasib or adagrasib. Independent reviewers who didn’t know the treatment judged progression.
What did the study find about lung cancer?
| Tumors that shrank, divarasib | 58.4% |
|---|---|
| Tumors that shrank, older pills | 32.3% |
| Grade 3 or 4 side effects, divarasib | 24.6% |
| Grade 3 or 4 side effects, older pills | 34.5% |
The hazard ratio for death was 0.56.
Why does this matter?
It’s rare for a new drug to beat an existing targeted drug head to head and also extend survival. This result suggests divarasib could become the preferred KRAS G12C pill, and it shows how quickly targeted lung cancer treatment is improving. A drug that is both more effective and easier to tolerate is the best of both worlds for patients, who often stay on these pills for many months. It also confirms that testing every advanced lung tumor for genetic changes matters, because the right pill depends on the mutation.
How solid is this evidence?
It’s strong. Mongevity rates it A on our A-to-E scale: a large international randomized phase 3 trial with blinded review and an overall survival benefit. Limits: it was open-label and funded by Roche, the maker, and most people in the comparison group got sotorasib.
What does this mean for you?
If you or someone close to you has advanced lung cancer, make sure the tumor has been tested for genetic changes, including KRAS G12C. If it’s present, ask the oncologist about the newest KRAS pills and clinical trials.
How do I explain this at dinner?
Some lung cancers have a broken switch called KRAS. Scientists made a newer pill that turns that switch off more strongly than older pills, and people lived longer. A good question for the table: why do scientists keep improving medicines that already work?
In one sentence: divarasib beat first-generation KRAS G12C pills in lung cancer, extending both time without progression and survival, with fewer serious side effects.
Questions and answers
- What is KRAS G12C?
- A mutation in the KRAS gene found in some lung cancers, which can be targeted with specific pills.
- Is divarasib better than sotorasib or adagrasib?
- In this trial, median survival was 17.7 vs. 12.0 months, and tumors shrank in 58.4% vs. 32.3%.
- Does it have more side effects?
- Fewer: grade 3 or 4 side effects occurred in 24.6% vs. 34.5%.
