Guidelines for the combined use of sotoracib and chemotherapy drugs

Sotorasib (AMG510, Sotorasib) , as the first targeted drug approved for patients with KRAS G12C mutations, is gradually changing the treatment landscape for locally advanced or metastatic non-small cell lung cancer (NSCLC) and metastatic colorectal cancer (mCRC). Although its single-agent efficacy has been significant, the duration of efficacy is limited in some patients. Therefore, combination chemotherapy regimens have gradually received attention and become an important direction for multi-center research.

For non-small cell lung cancer, there are currently studies exploring the feasibility of combining sotoraxib with platinum drugs (such as carboplatin and cisplatin). Preliminary data show that combination therapy may prolong progression-free survival and enhance response rates in some people. This type of combination strategy is more suitable for complex cases with chemotherapy resistance and multiple gene mutations, but it may also increase adverse reactions such as gastrointestinal reactions and liver toxicity, so it needs to be carried out under strict medical monitoring.

For metastatic colorectal cancer (mCRC), the single-agent response rate of sotoraxib is limited, and combination regimens have become the focus of exploration. For example, combining it with the FOLFIRI (fluorouracil + leucovorin + irinotecan) regimen or an EGFR inhibitor such as cetuximab has shown higher tumor control rates. This type of combination mechanism is based on synergistic blockade of pathways and is particularly suitable for patients with KRAS G12C mutations but not yet extensive drug resistance.

Although sotorasibu has not yet been officially approved in mainland China, and the combination regimen is still in the clinical research stage, Hong Kong and some overseas countries can already apply for such regimens for personalized treatment. In actual clinical practice, whether to use chemotherapy drugs in combination should be comprehensively evaluated based on multiple indicators such as genetic testing results, drug-resistant mutation status, and the patient's liver and kidney function. As the global research on KRAS G12C targeted therapy continues to deepen, the combination therapy of sotoraxib and chemotherapy drugs is expected to become one of the standard treatments in the future, especially playing a key role in the upgrading of strategies after the failure of multi-line treatments.

Reference materials:https://www.lumakras.com/