Treatment of Metastatic Colon Cancer (pMMR/MSS) with KRAS G12C Mutation
This protocol applies to patients with metastatic colon adenocarcinoma whose tumours are proficient in mismatch repair (pMMR) and microsatellite stable (MSS), and who carry a KRAS G12C mutation. This molecular combination defines a clinically distinct subpopulation with specific treatment options.
Clinical Scenario
The patient has pMMR/MSS metastatic colon adenocarcinoma with a confirmed KRAS G12C mutation. Mismatch repair proficiency and microsatellite stability together exclude immunotherapy approaches that rely on high mutational burden, while the KRAS G12C variant opens a specific targeted pathway.
Treatment Approach
The protocol centres on a KRAS G12C-targeted agent, which may be used in combination with an EGFR-targeting antibody or, for patients with specific tolerability considerations, as monotherapy. The complete regimen options, selection criteria, and sequencing are available in the full structured protocol.
References
- pMMR/MSS
- (Adagrasib or sotorasib) + (cetuximab or panitumumab) (KRAS G12C mutation)
- Adagrasib or Sotorasib monotherapy (KRAS G12C mutation)
- If patient is unable to tolerate EGFR inhibitor due to toxicity, single-agent adagrasib or sotorasib can be considered.