Genetic Abnormalities - KRAS

KRAS is one of the genes doctors look for when they test lung cancer for biomarkers. For many years, a KRAS mutation meant there was no drug that could target it directly. That has changed. Two drugs are now approved for 1 specific KRAS mutation in non-small cell lung cancer (NSCLC).^1-3

Role of KRAS

Genes carry the instructions your cells use to make proteins. The KRAS gene tells cells to make a protein that helps control when a cell grows and divides. In a healthy cell, that protein switches on when growth is needed and switches off again afterward.^1,4

When the KRAS gene is mutated, the protein can get stuck in the “on” position. Cells then keep growing and dividing when they should stop. This uncontrolled growth is part of how cancer develops.^1,4

Targeting KRAS

About 1 in 8 people with NSCLC have a specific change called a KRAS G12C mutation. Two drugs are approved to treat it:^1-6

• Lumakras® (sotorasib) – Approved in May 2021 for adults with KRAS G12C-mutated advanced or metastatic NSCLC who have already had at least 1 other systemic treatment.
• Krazati® (adagrasib) – Approved in December 2022 for the same group of adults.

Both drugs attach to the KRAS G12C protein and help stop cancer cells from growing.¹

Two things are important to know about these approvals. Both were granted through the FDA’s accelerated approval pathway. This means they were approved on early results, and continued approval may depend on later trials confirming the benefit.^2,3

Both also require a specific test. Your tumor or a blood sample must be tested with an FDA-approved test to confirm the G12C mutation before you can take either drug. Biomarker testing is how your care team finds out whether a targeted drug is an option for you.^2-4

If your KRAS mutation is not G12C, these 2 drugs are not an option. Your doctor can talk with you about other treatments, including clinical trials.

Mutations to KRAS

KRAS mutations also affect how other drugs work. NSCLC with a KRAS mutation is often resistant to targeted drugs that work on a different gene, EGFR — drugs such as Tarceva® (erlotinib), Iressa® (gefitinib), and Gilotrif® (afatinib).¹

This is one reason biomarker testing matters. Knowing which mutation your cancer has helps your care team rule options in and out.¹

Talk to your doctor

If you have NSCLC, ask your care team whether your tumor has been tested for biomarkers, and whether KRAS was included. Test results can take time, and what they show may change over the course of your treatment. Treatment works differently for each person, and a drug that helps someone else may not be right for you. Your doctor can explain what your results mean for your own options.