Targeted drug sotorasiib vs adagrasiib: Which one is more suitable for patients?

When treatingKRAS G12C mutant non-small cell lung cancer (NSCLC) , the selection of targeted drugs is crucial to the patient's therapeutic effect. Sotorasib (AMG510, Sotorasib) andadagrasib (adagrasib)are new targeted drugs targetingKRAS G12C mutations. They have their own characteristics in terms of efficacy, drug resistance, indications and side effects. So, which drug is better for patients? When making a choice, the patient's specific circumstances need to be considered, including the progression of the cancer, the patient's physical condition, the side effects of the drug, and the patient's response to the drug.

1. Comparison of the efficacy of sotorasib and adagrasiib

Sotoracib and adagrasib are both targeted drugs that specifically target the KRAS G12C mutation, which is common in many types of cancer, especially non-small cell lung cancer. Sotoracib was first approved by the FDA in the United States and received market authorization in 2021. Its clinical study results show that sotoraxib has significant efficacy in patients with KRAS G12C mutated non-small cell lung cancer. In a phase III clinical study (CodeBreaK 100), sotorasiib demonstrated an overall response rate (ORR) of approximately 35%, with some patients having disease control for more than a year, and its side effects were relatively mild, with the most common being diarrhea, nausea and fatigue.

In contrast, clinical studies of adagrasib have also shown its efficacy, and have also achieved good results in patients with KRAS G12C mutated non-small cell lung cancer. Its Phase III clinical study (Krasnexus) showed that the overall response rate of adagrasiib was similar to that of sotorasib, about 40%. Some patients show better resistance to adagrasiib and maintain efficacy for a longer period of time. In addition, adagrasib has also shown efficacy in certain types of colorectal cancer with KRAS G12C mutations.

The efficacy of the two is not much different, and both can achieve good therapeutic effects in different KRAS G12C mutation patient groups. Therefore, the difference in efficacy is not an important factor in choosing between the two, and more considerations should focus on side effects and individualized treatment options.

2. Comparison of side effects

For patients, the side effects of targeted drugs are another key consideration. The side effects of sotoracib are relatively mild. The most common ones are digestive system reactions such as diarrhea, nausea, fatigue, and loss of appetite. Usually, the side effects can be alleviated after reducing the dose. Serious side effects occur relatively rarely. Most patients tolerate treatment with this drug.

The side effects of adagrasib are also relatively mild, but some patients have experienced problems such as abnormal liver function and musculoskeletal pain during the medication. Some patients may experience long-term elevation of liver enzymes and require regular monitoring of liver function. In addition, common side effects such as diarrhea, fatigue, and loss of appetite occur in some patients, but most side effects are manageable.

Taken together, although the side effects of both drugs are mild, adagrasiib may cause more obvious liver function abnormalities in some patients, so liver function needs to be tested regularly. The side effects of sotoracib are mainly gastrointestinal reactions, which are usually easier to manage. Patients should choose the most appropriate drug based on their personal physical condition and tolerance to the drug.

References：https://www.krazati.com/