A 64-year-old female patient, light current smoker was diagnosed in November 2019 with a cT2aN2M1c lung adenocarcinoma (EGFR wild-type, ALK/ROS1-, HER2-, PD-L1 < 1% by molecular assay). However, molecular testing via NGS panel sequencing revealed a KRAS p.G12C mutation.
Patient was started on pembrolizumab, pemetrexed, and carboplatin in December 2019. In March 2019, the patient began pemetrexed maintenance therapy, which was successfully completed. However, in late December 2020, metastases in the lung, adrenal gland, and brain were found during a routine follow-up scan. The patient has since received successful Gamma Knife surgery for the brain lesions. Repeat molecular testing has confirmed the presence of a KRAS p.G12C mutation. The patient has an ECOG PS
What treatment(s) would you recommend for this patient? What factors would you consider when deciding how to treat this patient?