Presentation and outcomes of KRASG12C mutant non-small cell lung cancer patients with stage IV disease at diagnosis (de novo) versus at recurrence

•Patients with metastatic KRASG12C-mutated NSCLC have few therapy options.•Patients who develop metastasis at recurrence may have better performance than patients with initial metastatic disease (de novo).•We found that de novo patients had more disease and were less fit for therapy compared to recurrent patients.•There is an urgent need for targeted therapy for patients with de novo KRASG12C–mutated NSCLCs.