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Cancer (oncology)

Sotorasib (sotorasib)

Sotorasib is a oral kras g12c inhibitor (small molecule, inhibitor of the ras gtpase family) from Amgen, marketed originally as Lumakras. This monograph covers approved indications, mechanism, dosing, side effects and the manufacturer landscape.

Overview

Sotorasib (Lumakras in the US, Lumykras in the EU) was the first medicine approved to target KRAS G12C, a mutation that had been considered undruggable for four decades. It is an oral, once-daily covalent inhibitor that traps the mutant KRAS G12C protein in its inactive, GDP-bound state and shuts down the RAS-MAPK signal that drives tumour growth. It is approved as a single agent for adults with KRAS G12C-mutated locally advanced or metastatic NSCLC who have already received at least one prior systemic therapy (accelerated approval, first granted 28 May 2021), and since January 2025 in combination with panitumumab for previously treated KRAS G12C-mutated metastatic colorectal cancer. Access is the central issue in Southeast Asia. Everyone. org records originator approval in Singapore, Malaysia, Thailand and the Philippines, but no BPOM approval in Indonesia, so many patients pay out of pocket. With no FDA- or EMA-approved generic on the market, the affordable options are nationally registered copies made in Laos - LuciSot (Lucius Pharmaceuticals, 120 mg x 56 tablets, Lao registration no. 04 L0960/23) and Sotoraib (Lao ASEAN Pharmaceutical & Food Co. , TLPH, 120 mg x 120 tablets, cleared by the Lao food and drug department on 4 July) - together with Bangladeshi brands Sotoras (Beacon Pharmaceuticals, 120 mg, 5 x 6 tablets) and Sotoxen (Everest Pharmaceuticals, 120 mg, 56 tablets). 21) per 120 mg tablet, i. e. No published bioequivalence data against Lumakras was found for any copy, and Lumakras itself remains under accelerated approval in NSCLC pending a confirmatory study that the FDA asked to be completed by February 2028.

How it works

Sotorasib locks onto the mutant KRAS G12C protein and switches it off. That protein normally keeps tumour cells dividing; blocking it slows or stops tumour growth. It does not act on normal (wild-type) KRAS.

Sotorasib is a covalent, selective inhibitor of KRAS G12C that traps the mutant protein in its inactive GDP-bound state, blocking the RAS-MAPK proliferation signal. The US label describes it as 'an inhibitor of the RAS GTPase family' (sotorasib molecular formula C30H30F2N6O3, MW 560. 6 g/mol).

Approved indications

  • As a single agent: adult patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), determined by an FDA-approved test, who have received at least one prior systemic therapy (accelerated approval, first approved 28 May 2021)
  • In combination with panitumumab: adult patients with KRAS G12C-mutated metastatic colorectal cancer (mCRC) who have received prior fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy (approved Jan 2025)

Dosage & administration

960 mg (three 320 mg tablets or four 240 mg tablets or eight 120 mg tablets) orally once daily, at the same time each day with or without food, until disease progression or unacceptable toxicity. Swallow tablets whole - do not chew, crush or split.

Dose adjustment

Maximum of two dose reductions: first reduction 480 mg once daily, second reduction 240 mg once daily; discontinue if unable to tolerate 240 mg once daily. For AST/ALT >3-5x ULN with symptoms or >5x ULN: withhold until recovery and resume at the next lower dose; for AST/ALT >3x ULN with total bilirubin >2x ULN: permanently discontinue unless another cause is identified. Confirmed ILD/pneumonitis: permanently discontinue. Avoid concomitant PPIs and H2-receptor antagonists; if an acid-reducing agent is needed, take sotorasib 4 hours before or 10 hours after a local antacid.

Side effects

Diarrhoea (42%, grade 3-4 in 5%) · Musculoskeletal pain · Nausea (26%) · Fatigue · Cough · Vomiting (17%) · Constipation (16%) · Abdominal pain (15%)

Serious reactions to watch for
  • Hepatotoxicity (27% of the pooled NSCLC population, 16% grade >=3; grade 3-4 ALT/AST increase in 9%)
  • Interstitial lung disease / pneumonitis (2. 2%, one fatal case; median onset 8. 6 weeks)

Monitoring

  • Liver function tests (ALT, AST, alkaline phosphatase and total bilirubin) before starting, every 3 weeks for the first 3 months, then once a month or as clinically indicated
  • Pulmonary symptoms for ILD/pneumonitis (dyspnoea, cough, fever)
  • Monitor patients with hepatic impairment more frequently
  • Review acid-reducing therapy (PPIs/H2 blockers) and separate local antacids by 4 hours before / 10 hours after the sotorasib dose

Generic and biosimilar landscape

No FDA- or EMA-approved generic sotorasib was identified. Lao copies (LuciSot by Lucius; Sotoraib by TLPH) are nationally registered in Laos and are not FDA/EMA-approved. No published bioequivalence study against Lumakras was found in this search. Lumakras remains under accelerated approval in NSCLC pending a confirmatory study (FDA requested completion by February 2028), which is relevant to how 'fully approved' comparisons should be framed.

Who makes it

ManufacturerCountryBrandStrengthNotes
Lucius Pharmaceuticals Laos LuciSot 120 mg x 56 tablets Confirmed on the manufacturer website; Lao registration no. 04 L0960/23; 24-month shelf life
Lao ASEAN Pharmaceutical & Food Co., Ltd - TLPH Laos Sotoraib 120 mg x 120 tablets Confirmed by the manufacturer's own news release: approved by the Lao Ministry of Health Food and Drug Department (FDD) on 4 July

Availability in Southeast Asia

CountryStatusNotes
Singaporeapproved (originator)everyone. org records HSA approval for KRAS G12C-mutated NSCLC; Amgen's press release also lists Singapore among approved markets
Malaysiaapproved (originator)everyone. org records NPRA approval for KRAS G12C-mutated NSCLC; aggregator source
Thailandapproved (originator)everyone. org records Thai FDA approval; Amgen's press release also lists Thailand among approved markets
Philippinesapproved (originator)everyone. org records FDA Philippines approval for KRAS G12C-mutated NSCLC; aggregator source
Indonesianot approvedeveryone. org records no BPOM approval and no public submission; access only via special importation or trials
LaosLao-made copies availableTwo Lao manufacturers (Lucius - LuciSot; TLPH - Sotoraib) hold Lao approvals for sotorasib

Frequently asked questions

What is sotorasib (Lumakras) used to treat?

Sotorasib is approved for: As a single agent: adult patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), determined by an FDA-approved test, who have received at least one prior systemic therapy (accelerated approval, first approved 28 May 2021); In combination with panitumumab: adult patients with KRAS G12C-mutated metastatic colorectal cancer (mCRC) who have received prior fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy (approved Jan 2025). It is a sotorasib (Oral KRAS G12C inhibitor), originally marketed as Lumakras (US); Lumykras (EU) by Amgen.

What dose of sotorasib is approved and why is it 960 mg once daily?

Standard dosing for sotorasib: 960 mg (three 320 mg tablets or four 240 mg tablets or eight 120 mg tablets) orally once daily, at the same time each day with or without food, until disease progression or unacceptable toxicity. Swallow tablets whole - do not chew, crush or split. Dose adjustments: Maximum of two dose reductions: first reduction 480 mg once daily, second reduction 240 mg once daily; discontinue if unable to tolerate 240 mg once daily. For AST/ALT >3-5x ULN with symptoms or >5x ULN: withhold until recovery and resume at the next lower dose; for AST/ALT >3x ULN with total bilirubin >2x ULN: permanently discontinue unless another cause is identified. Confirmed ILD/pneumonitis: permanently discontinue. Avoid concomitant PPIs and H2-receptor antagonists; if an acid-reducing agent is needed, take sotorasib 4 hours before or 10 hours after a local antacid.

Is sotorasib approved for colorectal cancer?

Sotorasib is approved for: As a single agent: adult patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), determined by an FDA-approved test, who have received at least one prior systemic therapy (accelerated approval, first approved 28 May 2021); In combination with panitumumab: adult patients with KRAS G12C-mutated metastatic colorectal cancer (mCRC) who have received prior fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy (approved Jan 2025). It is a sotorasib (Oral KRAS G12C inhibitor), originally marketed as Lumakras (US); Lumykras (EU) by Amgen.

What are the most common side effects of sotorasib?

The most frequently reported side effects of sotorasib are diarrhoea (42%, grade 3-4 in 5%), musculoskeletal pain, nausea (26%), fatigue, hepatotoxicity (27% of the pooled nsclc population, 16% grade >=3; grade 3-4 alt/ast increase in 9%), cough, vomiting (17%). Serious but less common reactions include hepatotoxicity (27% of the pooled nsclc population, 16% grade >=3; grade 3-4 alt/ast increase in 9%), interstitial lung disease / pneumonitis (2. 2%, one fatal case; median onset 8. 6 weeks). Routine monitoring: Liver function tests (ALT, AST, alkaline phosphatase and total bilirubin) before starting, every 3 weeks for the first 3 months, then once a month or as clinically indicated; Pulmonary symptoms for ILD/pneumonitis (dyspnoea, cough, fever); Monitor patients with hepatic impairment more frequently. Report any new or worsening symptom to your treating physician — most adverse effects are managed by dose reduction rather than stopping treatment.

Can sotorasib be taken with omeprazole or antacids?

Sotorasib (Oral KRAS G12C inhibitor (small molecule, inhibitor of the RAS GTPase family), originally Lumakras (US); Lumykras (EU) by Amgen) Sotorasib locks onto the mutant KRAS G12C protein and switches it off. That protein normally keeps tumour cells dividing; blocking it slows or stops tumour growth. It does not act on normal (wild-type) KRAS. 960 mg (three 320 mg tablets or four 240 mg tablets or eight 120 mg tablets) orally once daily, at the same time each day with or without food, until disease progression or unacceptable toxicity. Swallow tablets whole - do not chew, crush or split.

How long does sotorasib stay in the body (half-life)?

Elimination half-life: Mean terminal elimination half-life 5 hours (standard deviation 2); steady-state apparent clearance 26. 2 L/h (CV 76%) at 960 mg once daily. Dosing intervals are designed around this, which is why most regimens are once or twice daily.

Is there a generic sotorasib manufactured in Laos?

No FDA- or EMA-approved generic sotorasib was identified. Lao copies (LuciSot by Lucius; Sotoraib by TLPH) are nationally registered in Laos and are not FDA/EMA-approved. No published bioequivalence study against Lumakras was found in this search. Lumakras remains under accelerated approval in NSCLC pending a confirmatory study (FDA requested completion by February 2028), which is relevant to how 'fully approved' comparisons should be framed. Manufacturers supplying sotorasib generic versions include Lao ASEAN Pharmaceutical & Food Co. , Ltd - TLPH, Lucius Pharmaceuticals. Brands registered in Bangladesh include Sotoras, Sotoxen.

Does sotorasib cause liver toxicity or pneumonitis?

Sotorasib (Oral KRAS G12C inhibitor (small molecule, inhibitor of the RAS GTPase family), originally Lumakras (US); Lumykras (EU) by Amgen) Sotorasib locks onto the mutant KRAS G12C protein and switches it off. That protein normally keeps tumour cells dividing; blocking it slows or stops tumour growth. It does not act on normal (wild-type) KRAS. 960 mg (three 320 mg tablets or four 240 mg tablets or eight 120 mg tablets) orally once daily, at the same time each day with or without food, until disease progression or unacceptable toxicity. Swallow tablets whole - do not chew, crush or split.

How should sotorasib tablets be stored and taken?

Storage: Store at 20-25 C (68-77 F); excursions permitted from 15 to 30 C (59-86 F) Keep the product in its original packaging and check the expiry date printed on the pack.

Sources

  1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c80a362c-7ac3-4894-a076-0691e68ef8c1
  2. https://www.prnewswire.com/news-releases/amgen-presents-new-lumakras-sotorasib-plus-chemotherapy-data-in-first-line-kras-g12c-nsclc-at-wclc-301922393.html
  3. https://everyone.org/lumakras-sotorasib
  4. https://lucius-pharmaceuticals.com/zh-CN/drug/sotorasib
  5. http://cn.tlph.com.la/index.php/Index/artList/art_id/635/c_id/224.html
  6. https://ingpharma.com/goods-721.html
  7. https://www.syyiwuyou.com/newsinfo/37.html
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