The U.S. Food and Drug Administration granted accelerated approval to Krazati (adagrasib) plus cetuximab for adults with KRAS G12C-mutated locally advanced or metastatic colorectal cancer (CRC), marking a significant milestone in precision oncology for this patient population. The approval, announced on June 25, 2024, specifically targets patients whose tumors harbor the KRAS G12C mutation as determined by an FDA-approved test and who have received prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy.
Targeted Therapy for Genetic Mutation
The combination therapy addresses a specific genetic alteration that has historically been challenging to target in colorectal cancer treatment. KRAS G12C mutations represent a subset of colorectal cancer patients who may benefit from this precision medicine approach, requiring genetic testing to identify eligible candidates.
The accelerated approval pathway allows the FDA to approve drugs for serious conditions that fill an unmet medical need based on a surrogate endpoint. This regulatory mechanism enables earlier patient access to potentially beneficial treatments while confirmatory trials continue.
Safety Profile and Adverse Events
The most common adverse reactions occurring in at least 20% of patients treated with the Krazati and cetuximab combination included rash, nausea, diarrhea, vomiting, fatigue, musculoskeletal pain, hepatotoxicity, headache, dry skin, abdominal pain, decreased appetite, edema, anemia, cough, dizziness, constipation, and peripheral neuropathy.
Healthcare providers will need to monitor patients closely for these side effects and manage them appropriately to ensure optimal treatment outcomes. The comprehensive safety profile information will be available in the full prescribing information posted on Drugs@FDA.
Broader FDA Regulatory Activity
This approval was part of a broader set of FDA regulatory actions announced in late June 2024. The agency also converted Sirturo (bedaquiline) to traditional approval for multi-drug resistant tuberculosis following confirmatory trial results, and approved Vyvgart Hytrulo (efgartigimod alfa and hyaluronidase-qvfc) for chronic inflammatory demyelinating polyneuropathy in adults.
The FDA's continued focus on precision medicine approaches reflects the agency's commitment to advancing targeted therapies that address specific molecular characteristics of diseases, potentially improving outcomes for patients with limited treatment options.
