A KRAS G12C inhibitor is a type of targeted cancer therapy designed to inhibit a specific mutant form of the KRAS protein, where the glycine (G) at position 12 is replaced by cysteine (C) — hence ā€œG12Cā€. This mutation is a common driver mutation in several cancers, including:

Non-small cell lung cancer (NSCLC)

Colorectal cancer

Pancreatic cancer

Key Points: šŸ”¬ What is KRAS? KRAS is a gene that encodes a small GTPase, a protein involved in signaling pathways that control cell growth and division.

Mutations in KRAS can lead to uncontrolled cell growth and cancer.

šŸ’„ What makes G12C unique? The G12C mutation creates a unique binding pocket that is not present in the wild-type KRAS, allowing for selective targeting by small molecules.

Approved KRAS G12C Inhibitors: Sotorasib (Lumakras / AMG 510)

Approved by FDA for NSCLC with KRAS G12C mutation (2021).

Manufacturer: Amgen.

Adagrasib (Krazati / MRTX849)

Also FDA-approved for NSCLC and being evaluated for other tumors.

Manufacturer: Mirati Therapeutics (now part of Bristol Myers Squibb).

Mechanism of Action: These drugs irreversibly bind to the cysteine residue at the G12C mutation site.

They lock KRAS in its inactive GDP-bound state, preventing downstream signaling that promotes cancer cell survival and proliferation.

Clinical Considerations: Resistance mechanisms are emerging (e.g., secondary mutations in KRAS, pathway reactivation).

Combination therapies (e.g., with EGFR inhibitors or immune checkpoint inhibitors) are being explored in clinical trials.