Abstract::Sotorasib (SR), a first-in-class KRAS G12C inhibitor developed by Amgen, represents
a major advancement in the treatment of non-small cell lung cancer (NSCLC) with KRAS
G12C mutations. This comprehensive review covers the drug's development, mechanism of action,
pharmacokinetics, synthesis, and analytical methods. KRAS mutations, particularly KRAS
G12C, are associated with poor prognosis in NSCLC, with approximately 13% of cases harboring
this mutation. SR targets the KRAS G12C mutation by covalently binding to the cysteine
residue in the KRAS protein, inhibiting its signalling pathways and promoting tumour cell
death. Approved by the FDA in 2021, SR has demonstrated promising efficacy, including significant
objective response rates and progression-free survival benefits in pretreated patients
with NSCLC. The development of resistance mechanisms, such as secondary mutations and
alternative signalling pathways, remains a challenge, underscoring the need for ongoing research
into combination therapies and further trials. This review also highlights the drug’s synthetic
processes, structural features, and global patent coverage. SR approval marks a significant
milestone in KRAS-targeted therapies, offering new hope for patients with difficult-to-treat lung
cancer.