Adagrasib in the Treatment of KRAS p.G12C Positive Advanced NSCLC: Design, Development and Place in Therapy

Drug Des Devel Ther. 2024 Dec 5:18:5673-5683. doi: 10.2147/DDDT.S466217. eCollection 2024.

Abstract

One of the most common mutations seen in lung cancers are mutations in Kristen Rat Sarcoma Viral Oncogene Homolog (KRAS), observed in 25-30% of patients with NSCLC. Mutations in KRAS result in oncogenesis via persistent activation of the MAPK/ERK pathways. Although once thought to be "undruggable", KRAS p.G12C inhibitors such as sotorasib and adagrasib have been developed. This paper focuses on adagrasib, the second KRAS p.G12C inhibitor to obtain regulatory approval by the FDA and describes the details on its study design, development and current place in therapy.

Keywords: AMG510; CodeBreaK; KRYSTAL; Kristen Rat Sarcoma Viral Oncogene Homolog; MRTX849; brain penetration; sotorasib.

Publication types

  • Review

MeSH terms

  • Acetonitriles
  • Animals
  • Antineoplastic Agents* / chemistry
  • Antineoplastic Agents* / pharmacology
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / metabolism
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Drug Design
  • Drug Development
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / metabolism
  • Lung Neoplasms* / pathology
  • Mutation
  • Piperazines
  • Proto-Oncogene Proteins p21(ras)* / antagonists & inhibitors
  • Proto-Oncogene Proteins p21(ras)* / genetics
  • Proto-Oncogene Proteins p21(ras)* / metabolism
  • Pyrimidines / chemistry
  • Pyrimidines / pharmacology

Substances

  • Proto-Oncogene Proteins p21(ras)
  • KRAS protein, human
  • Antineoplastic Agents
  • adagrasib
  • Pyrimidines
  • Acetonitriles
  • Piperazines