Wang Ming-Xing, Zhu Pei, Shi Yue, Sun Qing-Ming, Dong Wan-Hui
Department of Medical Oncology, Lu'an Hospital of Traditional Chinese Medicine Affiliated to Anhui University of Chinese Medicine, Lu'an 237000, Anhui Province, China.
Department of Medical Oncology, Lu'an Hospital of Traditional Chinese Medicine, Lu'an 237000, Anhui Province, China.
World J Clin Cases. 2024 Sep 6;12(25):5805-5813. doi: 10.12998/wjcc.v12.i25.5805.
Lung cancer is increasing in incidence worldwide, and targeted therapies are developing at a rapid pace. Furthermore, the KRAS specific gene is strongly associated with non-small cell lung cancer (NSCLC). Adult patients with locally advanced or metastatic NSCLC who have tested positive for the KRAS G12C mutation and have progressed after at least one systemic treatment are treated with sotorasib.
In this study, we report on an advanced NSCLC with a KRAS G12C mutation. The histological diagnosis indicates stage IVB left lung adenocarcinoma with pelvic and bone metastases, identified as cT4N2bM1c. Using circulating tumor DNA analysis, it was possible to determine the mutation abundance of the KRAS gene exon 2, c.34G>Tp.G12C, which was 32.3%. The patient was advised to take sotorasib as part of their treatment. The imaging data were compared before and after treatment. Furthermore, clinical reassessments and regular serial blood testing were conducted. We found that the patient's clinical symptoms significantly improved after receiving sotorasib medication, and there were no notable side effects, such as liver toxicity, during the treatment.
Sotorasib has shown promising clinical efficacy in patients with the KRAS G12c mutation and has no apparent toxic side effects.
肺癌在全球范围内的发病率呈上升趋势，靶向治疗也在迅速发展。此外，KRAS特定基因与非小细胞肺癌（NSCLC）密切相关。经检测KRAS G12C突变呈阳性且在至少接受过一次全身治疗后病情进展的局部晚期或转移性NSCLC成年患者，采用索托拉西布进行治疗。
在本研究中，我们报告了一例患有KRAS G12C突变的晚期NSCLC。组织学诊断为IVB期左肺腺癌伴盆腔和骨转移，确定为cT4N2bM1c。通过循环肿瘤DNA分析，能够确定KRAS基因外显子2（c.34G>Tp.G12C）的突变丰度为32.3%。建议患者将索托拉西布作为治疗的一部分。比较了治疗前后的影像学数据。此外，还进行了临床重新评估和定期系列血液检测。我们发现患者在接受索托拉西布治疗后临床症状显著改善，且治疗期间未出现明显副作用，如肝毒性。
索托拉西布在KRAS G12c突变患者中显示出有前景的临床疗效，且无明显毒副作用。
