Sotorasib as Fourth-Line Treatment in Pancreatic Cancer: A Case Report and Literature Review.

Publisher: Rhode Island Medical Society Country of Publication: United States NLM ID: 101605827 Publication Model: Electronic Cited Medium: Internet ISSN: 2327-2228 (Electronic) Linking ISSN: 03637913 NLM ISO Abbreviation: R I Med J (2013) Subsets: MEDLINE

Original Publication: Providence, RI : Rhode Island Medical Society, [2013]-

Pancreatic Neoplasms*/drug therapy ; Pancreatic Neoplasms*/genetics ; Pancreatic Neoplasms*/pathology ; Adenocarcinoma*/drug therapy ; Adenocarcinoma*/genetics ; Adenocarcinoma*/pathology; Humans ; Female ; Aged ; Triazoles/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Proto-Oncogene Proteins p21(ras)/genetics ; Pyrimidines/therapeutic use ; Mutation ; Antineoplastic Agents/therapeutic use ; Irinotecan/therapeutic use ; Oxaliplatin/therapeutic use ; Fluorouracil/therapeutic use ; Leucovorin/therapeutic use ; Off-Label Use ; Piperazines ; Pyridines

The molecular pathogenesis of exocrine pancreatic cancer involves mutations K-RAS, TP53, CDKN2A, and SMAD4. The KRAS oncogene leads to constitutively active tumor cell proliferation and is present in 90% of unresectable or metastatic pancreatic adenocarcinomas. Of these, the G12C variant of K-RAS genes accounts for 1-2% of mutations. A 65-year-old woman initially diagnosed with T3N0M0 pancreatic adenocarcinoma, underwent six cycles of neoadjuvant chemotherapy with mFOLFIRINOX followed by Whipple procedure. Her pathological stage was T4N2. She then received adjuvant mFOLFIRINOX but unfortunately her disease progressed through multiple lines of chemotherapy. Molecular analysis by Next Generation Sequence(NGS) panel revealed KRAS G12C mutation. Based on this mutational status, she was started on Sotorasib to which she had clinical response lasting for about 11 months prior to disease progression. Off-label use of Sotorasib as fourth-line treatment in our patient with KRAS G12C mutated pancreatic cancer was efficacious and relatively well tolerated.

Keywords: KRAS mutation; Pancreatic cancer; Sotorasib; targeted therapy

2B2VM6UC8G (sotorasib)
0 (Triazoles)
EC 3.6.5.2 (Proto-Oncogene Proteins p21(ras))
0 (Pyrimidines)
0 (Antineoplastic Agents)
0 (KRAS protein, human)
7673326042 (Irinotecan)
04ZR38536J (Oxaliplatin)
U3P01618RT (Fluorouracil)
0 (folfirinox)
Q573I9DVLP (Leucovorin)
0 (Piperazines)
0 (Pyridines)

Date Created: 20240625 Date Completed: 20240625 Latest Revision: 20240910

20240910

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