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
References:
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