Rationale for Correct Answer

The correct answer is: Pembrolizumab plus chemotherapy

The NCCN preferred first line therapy for a patient with advanced lung adenocarcinoma carrying a KRAS G12C mutation is pembrolizumab plus carboplatin or cisplatin plus pemetrexed, a category 1 recommendation. Atezolizumab plus chemotherapy could be considered but is not a preferred option.1 The KRAS G12C inhibitors adagrasib and sotorasib are NCCN recommended for use in advanced NSCLC after at least 1 previous line of systemic therapy, reflecting their FDA approval status as second line therapies for patients with these mutations.1,2

1. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. Version 3.2023. Updated April 13, 2023. Available at: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1450

2. U.S. Food & Drug Administration (FDA). Oncology (Cancer) / Hematologic Malignancies Approval Notifications. Reviewed June 20, 2023. Accessed June 20, 2023. https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm279174.htm