Canadian Consensus Recommendations on the Management of KRAS G12C-Mutated NSCLC.
Activating mutations in Kirsten rat sarcoma viral oncogene homologue (KRAS), in particular, a point mutation leading to a glycine-to-cysteine substitution at codon 12 (G12C), are among the most frequent genomic alterations in non-small cell lung cancer (NSCLC). Several agents targeting KRAS G12C hav...
| Published in: | Current Oncology Vol. 30; no. 7; pp. 6473 - 6497 |
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| Main Authors: | , , , , , , , , , , , , |
| Format: | Journal Article |
| Published: |
MDPI
Jul2023
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=168598415&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 168598415 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11980052 5EKK jtl: Current Oncology issn: 11980052 maglogo: N pubinfo: dt: Jul2023 vid: 30 iid: 7 pid: 97109 pub: MDPI artinfo: ui: 168598415 10.3390/curroncol30070476 168598415 ppf: 6473 ppct: 24 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Canadian Consensus Recommendations on the Management of KRAS G12C-Mutated NSCLC. aug: au: Cheema, Parneet K. Banerji, Shantanu O. Blais, Normand Chu, Quincy S.-C. Juergens, Rosalyn A. Leighl, Natasha B. Sacher, Adrian Sheffield, Brandon S. Snow, Stephanie Vincent, Mark Wheatley-Price, Paul F. Yip, Stephen Melosky, Barbara L. affil: Division of Medical Oncology, William Osler Health System, University of Toronto, Brampton, ON L6R 3J7, Canada sug: ab: Activating mutations in Kirsten rat sarcoma viral oncogene homologue (KRAS), in particular, a point mutation leading to a glycine-to-cysteine substitution at codon 12 (G12C), are among the most frequent genomic alterations in non-small cell lung cancer (NSCLC). Several agents targeting KRAS G12C have recently entered clinical development. Sotorasib, a first-in-class specific small molecule that irreversibly inhibits KRAS G12C, has since obtained Health Canada approval. The emergence of novel KRAS-targeted therapies warrants the development of evidence-based consensus recommendations to help clinicians better understand and contextualize the available data. A Canadian expert panel was convened to define the key clinical questions, review recent evidence, and discuss and agree on recommendations for the treatment of advanced KRAS G12C-mutated NSCLC. The panel agreed that testing for KRAS G12C should be performed as part of a comprehensive panel that includes current standard-of-care biomarkers. Sotorasib, the only approved KRAS G12C inhibitor in Canada, is recommended for patients with advanced KRAS G12C-mutated NSCLC who progressed on guideline-recommended first-line standard of care for advanced NSCLC without driver alterations (immune-checkpoint inhibitor(s) [ICIs] +/− chemotherapy). Sotorasib could also be offered as second-line therapy to patients who progressed on ICI monotherapy that are not candidates for a platinum doublet and those that received first-line chemotherapy with a contraindication to ICIs. Preliminary data indicate the activity of KRAS G12C inhibitors in brain metastases; however, the evidence is insufficient to make specific recommendations. Regular liver function monitoring is recommended when patients are prescribed KRAS G12C inhibitors due to risk of hepatotoxicity. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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