The FDA has given accelerated approval to a drug – sotorasib – as a therapy for non-small cell lung cancer (NSCLC) that has KRAS G12C mutations. NSCLC is the most common type of lung cancer, and constitutes about 85% of all lung cancers. This is the form of lung cancer most associated with a history of smoking. It is significant when the FDA approves new lung cancer therapy such as sotorasib, as it provides optimism for patients and providers in battling difficult-to-treat NSCLCs.

KRAS mutations affect other cancers, as well as NSCLC, such as colorectal and pancreatic cancers. This genetic mutation drives more than 90% of pancreatic cancers. It impacts about 40% of NSCLC, and of those about 13% are driven by the G12C mutation. 

Until now, KRAS mutations have been considered resistant to drug therapy. It was sometimes called the “undruggable” target genetic mutation. Although the number of lung cancers that will now be potentially treatable with the new drug is relatively small, it opens up new possibilities for other KRAS-mutations cancers.

At MD Anderson they are working on developing a pancreatic cancer drug right now that combines MEK inhibitors and hydroxychloroquine (does this sound familiar?) to block KRAS in patients with advanced pancreatic cancer. An MD Anderson spokesman said:

“With the advent of newer targeted therapies in the past decade, we now have options for treating KRAS mutations with drugs. By combining direct inhibitors and downstream inhibitors of KRAS, the field is entering an exciting era of innovative clinical trials that have the potential to improve outcomes and improve survival for patients with this mutation.”

All of this represents the new frontier of cancer treatment: determining what genetic components drive development and growth of specific cancers, and then developing ways of blocking how the genetic mutation accomplishes this. This could, hopefully, just be one of the early steps in developing a series of therapies that really target these devastating cancers.