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Sotorasib + trastuzumab deruxtecan is a combination therapy being investigated for the treatment of advanced or metastatic non-small cell lung cancer (NSCLC) harboring the KRAS G12C mutation. This regimen combines sotorasib, a first-in-class small molecule that covalently inhibits the KRAS G12C mutant protein by locking it in an inactive GDP-bound state, with trastuzumab deruxtecan (T-DXd), a HER2-directed antibody-drug conjugate. T-DXd consists of a humanized anti-HER2 IgG1 monoclonal antibody linked to a topoisomerase I inhibitor payload (deruxtecan) via a cleavable tetrapeptide linker. The National Cancer Institute (NCI) is sponsoring Phase I/II clinical trials to evaluate the safety and efficacy of this combination, potentially targeting cross-talk between the HER2 and KRAS signaling pathways to overcome resistance or enhance antitumor activity in KRAS-mutated lung cancers.
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