Sotorasib for Vascular Malformations Associated with KRAS G12C Mutation

N Engl J Med. 2024 Jul 25;391(4):334-342. doi: 10.1056/NEJMoa2309160. Epub 2024 Jul 17.

Abstract

KRAS gain-of-function mutations are frequently observed in sporadic arteriovenous malformations. The mechanisms underlying the progression of such KRAS-driven malformations are still incompletely understood, and no treatments for the condition are approved. Here, we show the effectiveness of sotorasib, a specific KRAS G12C inhibitor, in reducing the volume of vascular malformations and improving survival in two mouse models carrying a mosaic Kras G12C mutation. We then administered sotorasib to two adult patients with severe KRAS G12C-related arteriovenous malformations. Both patients had rapid reductions in symptoms and arteriovenous malformation size. Targeting KRAS G12C appears to be a promising therapeutic approach for patients with KRAS G12C-related vascular malformations. (Funded by the European Research Council and others.).

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Arteriovenous Malformations* / diagnosis
  • Arteriovenous Malformations* / diagnostic imaging
  • Arteriovenous Malformations* / drug therapy
  • Arteriovenous Malformations* / genetics
  • Cardiovascular Agents / therapeutic use
  • Disease Models, Animal
  • Female
  • Gain of Function Mutation
  • Humans
  • Male
  • Mice
  • Middle Aged
  • Mutation
  • Piperazines / therapeutic use
  • Proto-Oncogene Proteins p21(ras)* / genetics
  • Pyridines / therapeutic use
  • Pyrimidines
  • Young Adult

Substances

  • KRAS protein, human
  • Piperazines
  • Proto-Oncogene Proteins p21(ras)
  • Pyridines
  • Pyrimidines
  • sotorasib
  • Cardiovascular Agents