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Thoracic Malignancies • Medical Oncology • NCI-CCC Tumor Board Question • Non-small cell lung cancer • Vanderbilt • NCI-CCC Thoracic Tumor Board Question
For patients with KRAS G12C mutated NSCLC, how would you decide between using targeted therapy with sotorasib vs adagrasib?
Is there anything to differentiate the two agents? CNS penetration reportedly with adagrasib, FDA accelerated approval has been given with sotorasib.
Phase II publication
Answer from: Medical Oncologist at Academic Institution
Sotorasib is currently my drug of choice for now, since it is FDA approved. The KRYSTAL-1 results for adagrasib were presented at ASCO 2022, and the efficacy is very similar vs sotorasib, 43% vs 37% ORR, 80% DCR for both, 6.5 vs 6.8 mo mPFS, and 12.6 vs 12.5 mo mOS. Adagrasib does seem to have more ...
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Answer from: Medical Oncologist at Community Practice
The incidence of CNS metastases in KRASG12Cmutated NSCLC is approximately 27 to 42% at diagnosis and is associated with a poor prognosis. The current standard of care for this group of patients is docetaxel plus ramucirumab which is associated with a median PFS of approximately 3 to 5 months. (...