KRAS-G12 inhibitors in lung cancer therapy: unveiling the toxicity profile through a pharmacovigilance study.

Abstract

Background: With the advent of drugs designed to selectively target the KRAS-G12C mutant protein, sotorasib and adagrasib have exhibited remarkable efficacy in patients with KRAS G12C mutant lung cancers. Nevertheless, the safety profiles of these agents in a real-world context remain undisclosed.

Methods: Data was systematically extracted from the FDA Adverse Event Reporting System (FAERS) website from January 2021 to December 2023, focusing on adverse events associated with KRAS G12C inhibitors, sotorasib and adagrasib.

Results: The predominant adverse events attributed to KRAS G12C inhibitors predominantly encompassed general disorders and administration site conditions, investigations, and gastrointestinal disorders. Among these, the significant adagrasib-related adverse events comprised nausea, diarrhea, vomiting, asthenia, dizziness, and weight loss. Notably, incidences of renal failure were also documented in patients receiving adagrasib. Conversely, the primary adverse events associated with sotorasib included diarrhea, nausea, abnormal hepatic function, elevated levels of aspartate aminotransferase and alanine aminotransferase, and hepatotoxicity. It is noteworthy that a considerable number of adverse events manifested within the inaugural month following the initiation of therapy with KRAS G12C inhibitors.

Conclusion: Although most adverse effects are reversible, vigilance is warranted particularly for nephrotoxicity and hepatotoxicity during the administration of KRAS G12C inhibitors.