How to treat adverse reactions caused by Sotorasib?

Introduction: Sotorasib is used to treat a certain type of lung cancer that has spread to other parts of the body or cannot be removed by surgery. It is suitable for adults who have received at least one other treatment. Sotorasib belongs to a class of drugs called KRAS inhibitors, which work by blocking the action of abnormal proteins that signal cancer cells to proliferate, helping to stop or slow the spread of cancer cells.

Adverse reactions of Sotorasib

1. Nausea and diarrhea: are the more common mild to moderate gastrointestinal adverse reactions of .

2. Fatigue: Patients taking sotorasibu may feel fatigue or weakness.

3. Abnormal liver function: including elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), which may require regular monitoring of liver function.

4. Cough: Some patients may have the adverse reaction of coughing.

5. Musculoskeletal pain: Patients treated with sotoracib may experience muscle or bone pain.

Measures for dealing with adverse reactions of Sotorasib

1. Hepatotoxicity: Sotorasib may cause hepatotoxicity. It is recommended to regularly monitor liver function, including ALT, AST, total bilirubin and other indicators before starting treatment and during treatment. If a patient develops elevated transaminases and/or bilirubin, consideration should be given to suspending, reducing the dose, or permanently discontinuing sotoraxib, depending on the severity of the adverse reaction.

2. Interstitial lung disease (ILD)/pneumonitis: Sotorasiib may cause ILD/pneumonitis, which may be fatal in severe cases. Physicians should monitor patients for new or worsening pulmonary symptoms, such as dyspnea, cough, or fever. If ILD/pneumonia is suspected, sotoraxib should be discontinued immediately and permanent discontinuation should be considered if confirmed.

3. Diarrhea, nausea and fatigue: Symptomatic treatment may be required, such as using antidiarrheal drugs, anti-nausea drugs, or adjusting diet and lifestyle habits to reduce symptoms.

4. Adjust the dose: If the patient experiences adverse reactions when using sotoraxib, the dose may need to be adjusted. The recommended initial dose is 960 mg daily, but if intolerance occurs, the dose can be reduced to 480 mg and further reduced to 240 mg. If 240 mg is still not tolerated, sotoraxib should be discontinued.

Efficacy of sotoracib

In a multi-center, randomized, open-label, active-controlled, confirmatory phase 3 study to compare the efficacy of sotoraxib with docetaxel in the ITT population, a total of 345 patients were recruited and randomly assigned to receive oral 960 mg sotoraxib (n=171) or intravenous 75 mg/m² docetaxel (n=174) every 3 weeks.

The median follow-up time was 17.7 months. Compared with docetaxel, the risk of disease progression or death was reduced by 34% in the sotoraxib group. Median PFS was 5.6 months in the sotorasib group and 4.5 months in the docetaxel group. The 12-month PFS rate of the sotoracib group was 24.8%, and that of the docetaxel group was 10.1%. was better.