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Addition of Selumetinib to Docetaxel in KRAS-Mutant Lung Cancer

In patients with previously treated advanced KRAS-mutant non–small cell lung cancer (NSCLC), adding the MEK inhibitor selumetinib to docetaxel did not improve progression-free survival, according to the findings of the randomized phase III SELECT-1 clinical trial. Pasi A. Jänne, MD, PhD, of the Dana-Farber Cancer Institute, and colleagues reported these results in a recent issue of JAMA. In addition, no significant improvement in overall survival was reported with the combination therapy.

A total of 510 patients with previously treated locally advanced or metastatic disease from 202 sites in 25 countries were included in this double-blind trial. Among these patients, 94% had KRAS codon 12 or 13 mutations, and 91% had adenocarcinoma histology.

The investigators found no significant improvement in progression-free survival with selumetinib plus docetaxel compared with placebo plus docetaxel (median, 3.9 months vs 2.8 months; P=.44). In addition, no significant interactions of treatment by subgroup were noted. The median overall survival was 8.7 months vs 7.9 months, respectively (P=.64).