Indications
Sotorasib is a targeted cancer medicine used in adults with:
- Advanced or spread non-small cell lung cancer (NSCLC) whose tumour has a specific gene change called KRAS G12C, usually after at least one earlier treatment
- In some countries, advanced bowel (colorectal) cancer with the KRAS G12C change, together with another medicine, Panitumumab
A test on the tumour or blood must confirm the KRAS G12C change before treatment.
How It Works
KRAS is a protein that acts like an on/off switch for cell growth. The G12C change leaves the switch stuck “on”, driving the cancer to grow. Sotorasib attaches permanently to the faulty KRAS G12C protein and locks it in its “off” state, which slows or stops the growth of cancer cells.
Dosage and Administration
Sotorasib tablets are taken by mouth once daily at about the same time each day, with or without food, at the dose prescribed by the cancer specialist. Swallow tablets whole. If you cannot swallow them, your care team can explain how to disperse them in water. The doctor may reduce or pause the dose if side effects occur. If you miss a dose by more than 6 hours, or vomit after a dose, skip it and take the next dose at the usual time.
Interactions
Avoid acid-reducing medicines such as proton pump inhibitors (Omeprazole, Esomeprazole) and H2 blockers (Famotidine), as they reduce the absorption of sotorasib; if an antacid is needed, take it at least 4 hours before or 10 hours after sotorasib, as advised. Strong enzyme inducers such as Rifampicin, Carbamazepine, Phenytoin and St John’s wort reduce its effect. Sotorasib can lower levels of some medicines broken down by CYP3A4 and can raise levels of Digoxin. Tell your doctor about every medicine and supplement you take.
Contraindications
Do not take sotorasib if you are allergic to it or any ingredient of the tablet.
Side Effects
Common side effects include:
- Diarrhoea, nausea, vomiting and abdominal pain
- Tiredness
- Muscle, joint or back pain
- Cough and shortness of breath
- Raised liver enzymes in blood tests
- Low red blood cells (anaemia)
Serious effects include liver damage and inflammation of the lungs (interstitial lung disease).
Get urgent medical help if you have yellowing of the skin or eyes, dark urine, pain on the right side of the abdomen, new or worsening cough or breathlessness with or without fever, severe or ongoing diarrhoea, or signs of a serious allergic reaction.
Pregnancy and Lactation
Sotorasib may harm an unborn baby. Women who could become pregnant should use effective contraception during treatment and for a period afterwards as advised by the specialist. Do not breastfeed during treatment and for 1 week after the last dose.
Precautions and Warnings
Liver blood tests are checked before starting, every few weeks for the first 3 months and then regularly. Tell your doctor about any liver or lung disease. Drink fluids and report diarrhoea early. Your doctor may change the dose depending on test results and side effects.
Overdose
There is limited information on overdose. Contact a doctor or go to hospital straight away; treatment is supportive and includes monitoring of liver function.
Therapeutic Class
Antineoplastic (anticancer) agent; KRAS G12C inhibitor.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Keep in the original pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.