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Lung cancer – sotorasib – a new weapon

BUY-SELL | HELP WANTED | MATRIMONIAL HI INDIA NEWS DESK By Dr. Nilesh D. Mehta Non-small cell lung cancer is a heterogeneous disease with an increasing number of actionable and emerging biomarkers. When lung cancer spreads to organs outside of the lung, it is generally incurable. For Stage IV lung cancer, chemotherapy used to be […]

BUY-SELL | HELP WANTED | MATRIMONIAL

HI INDIA NEWS DESK

By Dr. Nilesh D. Mehta

Non-small cell lung cancer is a heterogeneous disease with an increasing number of actionable and emerging biomarkers. When lung cancer spreads to organs outside of the lung, it is generally incurable. For Stage IV lung cancer, chemotherapy used to be the traditional therapy that was utilized to provide palliation for patients. Treatment for metastatic lung cancer has come a long way. Through precision medicine and molecular analysis of tumors, physicians are now able to target cancer cells which improves the response rates and thus providing a more meaningful quality of life.

Targeting mutations in lung cancer has become a standard practice in cancer treatment. It is important to realize that not all lung cancer patients have mutations. Molecular tests to identify whether cancer cells are expressing a “driver” mutation have continued to expand our treatment armamentarium essentially replacing the traditional chemotherapy approach. Several targeted medications are already in use for the treatment of lung cancer patients. KRAS G12C is the most prevalent emerging molecular target in non-small cell lung cancer ( adenocarcinoma of lung). 13% ( 1 in 8 ) of patients with non-small cell lung cancer have the KRAS G12C mutation which is nearly comparable to the other prevalent mutation – EGFR mutation ( in 15% of patients )

A new treatment, an oral medication, sotorasib was evaluated in CodeBreak 100 study which revealed very promising results in a phase 2 clinical trial. Sotorasib targets KRAS p.G12c mutation in lung cancer patients. In this study, where the majority of the patients had previously received chemotherapy and immunotherapy, the overall response rate in 124 evaluable patients was 37%. These data were published in the New England Journal of Medicine on June 4, 2021. Median duration of response was 11.1 months with median overall survival being 12.5 months. Tumor responses were observed in subgroups defined according to several characteristics including molecular expression of PD-L1, tumor mutational burden, as well as co-occurring mutations in STK11, KEAP1, or TP53.

This is an important advance yet again in the field of lung cancer treatment where identifying targets on the tumor cells is the key. Rather than “blast” cancer cells, scientists have developed an intelligent strategy over the last several years to study them and then selectively attack them.

Clinical trials with sotorasib, manufactured by Amgen, in other types of cancer are currently undergoing. Moving forward, any cancer patient whose tumor cells were to express KRAS p.G12c mutation could potentially benefit from sotorasib. Molecularly targeted medications are the future of oncology therapeutics.

These clinical data were discussed at the American Society of Clinical Oncology 2021 meeting that is being held virtually from June 4-8, 2021.

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