Frey Connor
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Pharmacoepidemiol Drug Saf. 2025 Feb;34(2):e70104. doi: 10.1002/pds.70104.
The p.G12C mutation in KRAS is commonly found in many cancers and was previously untreatable until drugs like sotorasib were developed. However, up to 15% of patients treated with sotorasib have experienced hepatobiliary adverse events. To investigate whether these side effects are more common among sotorasib users, a pharmacovigilance study is necessary.
This study used the FDA adverse event reporting system (FAERS) database, a publicly available repository of reported drug adverse events, and AERSMine, an open-access pharmacovigilance tool, to investigate these adverse events.
A total of 428 hepatobiliary adverse events were linked to sotorasib. Hepatic cytolysis had the highest reported relative risk at 26.541 and a safety signal of 4.726. Elevated liver and biliary enzymes such as AST, ALT, ALP, and GGT were commonly observed, but with lower reported relative risk and safety signal values, which supports previous real-world reports.
These findings highlight the hepatobiliary risks associated with sotorasib and underscore the importance of closely monitoring liver function in patients who are using the medication. This is particularly crucial for patients with hepatobiliary cancers, as disease progression and adverse events could be misinterpreted.
KRAS基因中的p.G12C突变在许多癌症中普遍存在,在索托拉西布等药物研发出来之前,该突变型癌症一直无法治疗。然而,接受索托拉西布治疗的患者中,高达15%出现了肝胆不良事件。为了调查这些副作用在索托拉西布使用者中是否更常见,开展一项药物警戒研究很有必要。
本研究使用了美国食品药品监督管理局不良事件报告系统(FAERS)数据库(一个公开的已报告药物不良事件储存库)和AERSMine(一个开放获取的药物警戒工具)来调查这些不良事件。
共有428例肝胆不良事件与索托拉西布有关。肝细胞溶解报告的相对风险最高,为26.541,安全信号为4.726。常见肝酶和胆汁酶如AST、ALT、ALP和GGT升高,但报告的相对风险和安全信号值较低,这与之前的真实世界报告相符。
这些发现突出了索托拉西布相关的肝胆风险,并强调了在使用该药物的患者中密切监测肝功能的重要性。这对患有肝胆癌的患者尤为关键,因为疾病进展和不良事件可能会被误解。