Prolonged Cancer Control With Adagrasib in Patients With Metastatic, KRAS^G12C-Mutated NSCLC After Sotorasib-Induced Hepatotoxicity: A Case Report

Both sotorasib and adagrasib are approved for use in metastatic KRAS^G12C-mutated NSCLC after cancer progression on chemotherapy and immunotherapy. Hepatoxicity is a commonly encountered adverse effect of both agents, and little data exists about the safety of sequential use of these agents when hepatotoxicity is encountered. In this case report, we describe a patient who developed recurrent hepatotoxicity with sotorasib and was able to switch to adagrasib without hepatotoxicity and subsequently experienced a prolonged cancer response. We also describe a previously unreported adagrasib adverse effect of photoinduced skin hyperpigmentation.