First KRAS Inhibitor OK’d for Colorectal Cancer

Thanks to a green light from the FDA, adagrasib (Krazati) has become the first KRAS^G12C inhibitor approved for colorectal cancer. Specifically, the Bristol Myers Squibb/Mirati Therapeutics drug plus the EGFR inhibitor cetuximab (Erbitux; Lilly) may now be used to treat adults with KRAS^G12C-mutated locally advanced or metastatic colorectal cancer who have already tried fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy. The decision was based on data from KRYSTAL-1, a multicenter, single-arm expansion cohort trial. Among 94 patients, the overall response rate was 34%, and all responses were partial responses. The median duration of response (DOR) was 5.8 months, but 31% of responding patients had a DOR of at least 6 months. Some of the most common adverse reactions were rash, nausea, diarrhea, vomiting, and fatigue.