Adagrasib is a KRASG12C inhibitor used to treat non-small cell lung cancer carrying KRASG12C mutations.

1. Usage and dosage

(1) Standard dose: Take 600mg (200mg tablets x 3) orally daily, on an empty stomach or with meals.

(2) Dose adjustment: When grade 3 or above adverse reactions occur, the administration should be suspended until it returns to ≤ grade 1, and then gradually reduced by 200mg.

2 Pregnant women

(1) Based on animal studies showing embryotoxicity, pregnant women should avoid using adagrasib.

(2) Women of childbearing age need to confirm their pregnancy status before treatment, and effective contraceptive measures should be taken during treatment and one week after discontinuation of medication.

3 lactating women

(1) There is currently no data on the distribution of adagracilib in breast milk. It is recommended to suspend breastfeeding during treatment and for one week after the last dose.

(2) It is necessary to weigh the impact of suspending breastfeeding on infant nutrition and the potential risks of medication.

4 pediatric patients

(1) The safety and efficacy of pediatric use for patients under 18 years old have not been established, and it is currently not recommended.

(2) The clinical trial for adolescents is currently underway and requires further data support.

5 elderly patients

(1) Patients aged 65 and above do not need to adjust their dosage, but close monitoring of changes in liver and kidney function is necessary.

(2) Patients with combined cardiovascular diseases need to strengthen QT interval monitoring as the risk of age-related cardiac conduction abnormalities increases.

6 Liver function impairment

(1) Mild impairment (Child Pugh A): No dose adjustment is required, but transaminase monitoring is required every 2 weeks.

(2) Moderate to severe damage (Child Pugh B/C): It is recommended to reduce the dosage to 400mg twice daily. If grade 3 liver toxicity occurs, the medication should be permanently discontinued.

7 Renal dysfunction

(1) Mild to moderate damage (eGFR30-89mL/min): No dose adjustment required.

(2) Severe impairment (eGFR<30mL/min) or dialysis patients: lack of data, it is recommended to use with caution and monitor for adverse reactions.