KRAS G12C抑制剂在实体肿瘤中的效力和安全性:系统综述。

IF 1.9 4区 医学 Q3 ONCOLOGY
Clinical Medicine Insights-Oncology Pub Date : 2025-04-22 eCollection Date: 2025-01-01 DOI:10.1177/11795549251331759
Sara El Zaitouni, Abdelilah Laraqui, Youssra Boustany, Soukaina Benmokhtar, Hicham El Annaz, Rachid Abi, Mohamed Rida Tagajdid, Safae El Kochri, El Arbi Bouaiti, Idriss Lahlou Amine, Rabii Ameziane El Hassani, Khalid Ennibi
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引用次数: 0

摘要

背景:Kirsten大鼠肉瘤病毒癌基因同系物(KRAS)基因,特别是半胱氨酸残基突变KRAS (G12C),作为KRAS突变实体癌患者的治疗靶点受到了极大的关注。尽管有这种兴趣,KRAS G12C抑制剂的有效性和安全性仍然不完全清楚。在本研究中,我们综合评估了相关KRAS G12C抑制剂(Sotorasib、Adagrasib、Garsorasib和Divarasib)在结直肠癌(CRC)、非小细胞肺癌(NSCLC)和胰腺导管腺癌(PDAC)患者中的有效性和毒性。方法:我们的系统评价以系统评价和荟萃分析指南的首选报告项目为指导。我们回顾了KRAS G12C抑制剂在KRAS G12C突变实体瘤中的现有临床试验数据。我们检索了PubMed、EMBASE、Cochrane Library和主要的国际会议,检索了2020年1月至2023年8月的临床试验。结果:共纳入17项符合条件的研究。在7项研究中分别报道了Sotorasib(41.2%)和Adagrasib(41.2%)对KRAS G12C的抑制作用。2项研究报告了Divarasib(11.8%), 1项研究报告了Garsorasib(6.7%)。Sotorasib在客观缓解率(ORR)(7.1%-47%)、无进展生存期(PFS)(4-6.8个月)和总生存期(OS)(4-24个月)方面显示出显著的临床益处;对于OS为2年,PFS为6.3个月,ORR为41%的非小细胞肺癌患者更有效。Adagrasib在ORR(19%-53%)、PFS(3.3-11.1个月)和OS(10.5-23.4个月)方面也显示出显著的临床活性,在OS为23.4个月、PFS为11.1个月、ORR为53.3%的NSCLC患者中更有效。Adagrasib在PDAC患者中的ORR为35.1%,PFS为7.4个月,OS为14个月,而Sotorasib的ORR为21%,PFS为4个月,OS为6.9个月。然而,Adagrasib和Sotorasib在CRC临床试验中是中等有效的。结论:本研究证实,这些KRAS G12C抑制剂单独或与常规疗法联合治疗的患者获得更好的治疗反应并调节这些实体瘤的进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Potency and Safety of <i>KRAS</i> G12C Inhibitors in Solid Tumors: A Systematic Review.

Potency and Safety of <i>KRAS</i> G12C Inhibitors in Solid Tumors: A Systematic Review.

Potency and Safety of <i>KRAS</i> G12C Inhibitors in Solid Tumors: A Systematic Review.

Potency and Safety of KRAS G12C Inhibitors in Solid Tumors: A Systematic Review.

Background: The Kirsten rat sarcoma viral oncogene homolog (KRAS) gene, specifically the cysteine residue mutation KRAS (G12C), has garnered significant attention as a therapeutic target for solid cancer patients with KRAS mutations. Despite this interest, the efficacy and safety profiles of KRAS G12C inhibitors remain incompletely understood. In this study, we comprehensively evaluate the effectiveness and toxicity of relevant KRAS G12C inhibitors (Sotorasib, Adagrasib, Garsorasib, and Divarasib) in patients with colorectal cancer (CRC), non-small-cell lung cancer (NSCLC), and pancreatic ductal adenocarcinomas (PDAC).

Methods: Our systematic review is guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We review the available clinical trials data on KRAS G12C inhibitors in KRAS G12C-mutated solid tumors. We searched PubMed, EMBASE, Cochrane Library, and major international conferences for clinical trials from January 2020 until August 2023.

Results: A total of 17 eligible studies were included. KRAS G12C inhibitions with Sotorasib (41.2%) and Adagrasib (41.2%) each of them were reported in 7 studies. Divarasib was reported in 2 studies (11.8%) and Garsorasib was reported in 1 study (6.7%). Sotorasib showed a significant clinical benefit in terms of objective response rate (ORR) (7.1%-47%), progression-free survival (PFS) (4-6.8 months), and overall survival (OS) (4-24 months); it is more efficient in NSCLC patients with an OS of 2 years, PFS of 6.3 months, and an ORR of 41%. Adagrasib also showed significant clinical activity with an ORR (19%-53%), PFS (3.3-11.1 months), and OS (10.5-23.4 months), with more effectiveness in NSCLC patients with an OS of 23.4 months, PFS of 11.1 months, and an ORR of 53.3%. Adagrasib is more efficient with an ORR of 35.1%, PFS of 7.4 months, and an OS of 14 months in patients with PDAC, than Sotorasib which showed an ORR of 21%, PFS of 4 months, and an OS of 6.9 months. However, Adagrasib and Sotorasib are moderately efficient in CRC clinical trials.

Conclusion: This study confirms that patients treated with these KRAS G12C inhibitors, exclusively or combined with conventional therapies, achieve better treatment responses and modulate the progressions of these solid tumors.

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来源期刊
CiteScore
2.40
自引率
4.50%
发文量
57
审稿时长
8 weeks
期刊介绍: Clinical Medicine Insights: Oncology is an international, peer-reviewed, open access journal that focuses on all aspects of cancer research and treatment, in addition to related genetic, pathophysiological and epidemiological topics. Of particular but not exclusive importance are molecular biology, clinical interventions, controlled trials, therapeutics, pharmacology and drug delivery, and techniques of cancer surgery. The journal welcomes unsolicited article proposals.
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