What is Adagrasib: Uses, Dosage, Side Effects and More

Adagrasib is a targeted cancer medication that blocks specific proteins helping certain tumors grow. It's designed to treat advanced lung cancer and colorectal cancer that carry a particular genetic mutation called KRAS G12C. This oral medication represents a breakthrough in precision medicine, offering hope for patients whose cancers were previously difficult to treat with traditional therapies.

What is Adagrasib?

Adagrasib is a prescription cancer drug that belongs to a class called KRAS G12C inhibitors. It works by targeting and blocking a mutated protein that drives cancer cell growth in specific types of tumors. The medication was developed specifically for cancers that test positive for the KRAS G12C mutation, which occurs in about 13% of lung cancers and 3% of colorectal cancers.

This medication is considered a targeted therapy rather than traditional chemotherapy. Unlike chemotherapy that affects both healthy and cancer cells, adagrasib specifically targets the mutated KRAS protein found only in cancer cells. This precision approach often leads to fewer side effects compared to conventional cancer treatments.

What is Adagrasib Used For?

Adagrasib is primarily used to treat two specific types of advanced cancer in adults. Your doctor will only prescribe this medication if your tumor tests positive for the KRAS G12C mutation through specialized genetic testing.

The medication treats non-small cell lung cancer that has spread to other parts of your body or cannot be removed with surgery. It's specifically approved for patients who have already tried at least one other systemic therapy. Many patients with this type of lung cancer had limited treatment options before adagrasib became available.

Adagrasib also treats advanced colorectal cancer that has spread beyond the colon or rectum. For colorectal cancer, it's used when the cancer has progressed after treatment with fluoropyrimidine-based, oxaliplatin-based, and irinotecan-based chemotherapy regimens. This represents a significant advancement for patients with KRAS G12C-positive colorectal cancer, which historically had poor treatment outcomes.

How Does Adagrasib Work?

Adagrasib works by blocking the KRAS G12C protein that acts like a faulty switch in cancer cells. In healthy cells, the KRAS protein normally helps control cell growth and division. When this protein becomes mutated to KRAS G12C, it gets stuck in the "on" position, causing cells to grow and divide uncontrollably.

This medication is considered a strong and highly specific targeted therapy. It binds directly to the mutated KRAS G12C protein and locks it in an inactive state. This stops the cancer cells from receiving the signals they need to grow and multiply, potentially shrinking tumors or slowing their growth.

Unlike broader cancer treatments, adagrasib's precision targeting means it primarily affects cancer cells while leaving healthy cells largely undisturbed. This selective approach often results in better tolerance and fewer severe side effects compared to traditional chemotherapy regimens.

How Should I Take Adagrasib?

Adagrasib comes as tablets that you take by mouth twice daily, approximately 12 hours apart. The standard dose is 600 mg twice daily, which equals four 150 mg tablets each time. Your doctor may adjust your dose based on how you respond to treatment and any side effects you experience.

You should take adagrasib with food to help your body absorb the medication properly. Having a meal or substantial snack when you take your dose can reduce stomach upset and improve how well the medicine works. Try to take your doses at the same times each day to maintain consistent levels in your bloodstream.

Swallow the tablets whole with a full glass of water. Don't crush, chew, or split the tablets, as this can affect how the medication is released in your body. If you have trouble swallowing tablets, talk to your healthcare team about strategies that might help.

Avoid grapefruit and grapefruit juice while taking adagrasib, as these can interfere with how your body processes the medication. Also, let your doctor know about any other medications or supplements you're taking, as some can interact with adagrasib.

How Long Should I Take Adagrasib For?

You'll typically continue taking adagrasib for as long as it's helping control your cancer and you're tolerating it well. This could be months or even years, depending on how your cancer responds to treatment. Your doctor will regularly monitor your progress through scans and blood tests to determine if the medication is working effectively.

Treatment duration varies significantly from person to person based on several factors. Some patients may need dose adjustments or temporary breaks if they experience side effects. Others might continue on the same dose for extended periods if their cancer remains stable or shrinks.

Your oncologist will schedule regular check-ups to assess your response to treatment and monitor for any concerning changes. These appointments typically include physical exams, blood work, and imaging scans every few months. Based on these results, your doctor will decide whether to continue, modify, or stop your adagrasib treatment.

What Are the Side Effects of Adagrasib?

Like all cancer medications, adagrasib can cause side effects, though not everyone experiences them. Most side effects are manageable with proper medical care and monitoring. Your healthcare team will work closely with you to prevent or minimize any uncomfortable symptoms.

The most common side effects that many patients experience include fatigue, nausea, and diarrhea. These typically develop within the first few weeks of treatment as your body adjusts to the medication:

• Fatigue or feeling more tired than usual
• Nausea and occasional vomiting
• Diarrhea or loose stools
• Decreased appetite
• Muscle or joint pain
• Skin rash or dry skin
• Headache

These common side effects are usually mild to moderate and often improve as your body adapts to the treatment. Your doctor can prescribe medications to help manage nausea and diarrhea if needed.

Some patients may experience more serious side effects that require immediate medical attention. While these are less common, it's important to recognize them early:

• Severe diarrhea that doesn't respond to treatment
• Signs of liver problems like yellowing of skin or eyes
• Unusual bleeding or bruising
• Severe fatigue or weakness
• Persistent fever or signs of infection
• Severe skin reactions

Contact your healthcare team immediately if you experience any of these more serious symptoms. They can provide guidance on managing side effects and may adjust your treatment plan if necessary.

Who Should Not Take Adagrasib?

Adagrasib isn't suitable for everyone, and your doctor will carefully evaluate whether it's right for you. Certain medical conditions or circumstances may make this medication unsafe or less effective for your specific situation.

You shouldn't take adagrasib if you're pregnant or planning to become pregnant. This medication can harm a developing baby, so reliable contraception is essential during treatment and for several weeks after stopping. Women of childbearing age will need pregnancy tests before starting treatment.

Breastfeeding mothers should not take adagrasib, as the medication can pass into breast milk and potentially harm a nursing infant. Your doctor will discuss safe feeding alternatives if you need this treatment while you have a young child.

People with severe liver problems may not be able to take adagrasib safely, as the medication is processed through the liver. Your doctor will check your liver function with blood tests before starting treatment and monitor it regularly throughout your therapy.

If you're taking certain medications that interact with adagrasib, your doctor may need to adjust doses or choose alternative treatments. This includes some blood thinners, heart medications, and other cancer drugs. Always provide your healthcare team with a complete list of all medications and supplements you're taking.

Adagrasib Brand Name

Adagrasib is sold under the brand name Krazati in the United States. This is the only brand name currently available for this medication, as it's a newer targeted therapy that was recently approved by the FDA.

When you pick up your prescription, you'll see "Krazati" on the bottle along with the generic name "adagrasib." Both names refer to the same medication, but your insurance and pharmacy records may use either name. If you have questions about your prescription, you can always ask your pharmacist to confirm you're receiving the correct medication.

Adagrasib Alternatives

For patients with KRAS G12C-positive cancers, adagrasib is part of a new class of targeted therapies, but it's not the only option available. Sotorasib (brand name Lumakras) is another KRAS G12C inhibitor that works similarly to adagrasib and may be considered as an alternative treatment.

If targeted therapy isn't suitable for your situation, your oncologist might recommend traditional chemotherapy regimens. These could include platinum-based chemotherapy combinations, immunotherapy drugs like pembrolizumab, or other targeted therapies depending on additional genetic markers your cancer may carry.

Clinical trials may also offer access to newer experimental treatments for KRAS G12C-positive cancers. Your doctor can help you explore whether you might benefit from participating in research studies testing combination therapies or next-generation KRAS inhibitors.

Is Adagrasib Better Than Sotorasib?

Both adagrasib and sotorasib target the same KRAS G12C mutation, but they have some differences that might make one more suitable for your specific situation. Studies suggest that adagrasib may have better penetration into the brain, which could be important if you have cancer that has spread to the brain.

The side effect profiles are similar between the two medications, though some patients may tolerate one better than the other. Adagrasib is taken twice daily, while sotorasib is taken once daily, which might influence your preference based on your lifestyle and schedule.

Your oncologist will consider factors like your overall health, the extent of your cancer, previous treatments you've received, and your personal preferences when choosing between these options. Both medications represent significant advances in treating KRAS G12C-positive cancers, and the best choice varies from person to person.