How to use Adagrasib?

How to use Adagrasib?

Adagrasib is an oral tablet. The recommended dosage is twice daily with a fixed dose, approximately 12 hours apart between the two doses. Patients should swallow the tablet whole, without chewing, crushing, or splitting. After treatment initiation, it should be continued as long as clinical benefit is evident and side effects are manageable. Treatment should be discontinued once imaging or clinical symptoms confirm disease progression, or when intolerable toxicities occur. If a patient misses a dose and it is more than 8 hours before the next scheduled dose, the missed dose should be taken as soon as possible; if it is close to the time of the next dose, skip the missed dose and take the next dose as planned. Do not double the dose.

Required testing before treatment

Before initiating treatment with Adagrasib, physicians must confirm the presence of a KRAS G12C mutation in the patient's tumor tissue or plasma sample using a validated genetic testing method (e.g., polymerase chain reaction or next-generation sequencing). Only patients who test positive for this mutation can benefit from treatment with this drug. This is because Adagrasib specifically targets the G12C mutation subtype and has no significant inhibitory effect on other KRAS mutations (e.g., G12D, G12V) or wild-type KRAS. Using the drug without testing would not only be ineffective but could also delay appropriate treatment and increase unnecessary drug exposure risks.

Dose adjustment and treatment discontinuation

During treatment, physicians should decide whether to delay dosing, reduce the dose, or permanently discontinue the drug based on the severity of side effects experienced by the patient. For example, when intolerable diarrhea, nausea, vomiting, or abnormal liver function occurs, treatment may be temporarily withheld until symptoms resolve to Grade 1 or baseline level, then resumed at the original dose or a reduced dose. If intolerance persists after dose reduction, or if life-threatening serious adverse events occur, permanent discontinuation of Adagrasib should be considered. Specific dose levels and reduction schemes are detailed in the summary of product characteristics; patients must not adjust their dosing regimen on their own.