medRxiv PreprintsInternational7 October 2026
Prior immune checkpoint inhibitor exposure, treatment interval, and severe hepatotoxicity with sotorasib in KRAS G12C-mutant non-small-cell lung cancer: a systematic review and meta-analysis
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Background: Severe hepatotoxicity has been reported when sotorasib follows immune checkpoint inhibitor (ICI) therapy, and fixed washout intervals have been proposed. We assessed prior ICI exposure and the ICI-to-sotorasib interval as separate risk factors. Materials and methods: We searched PubMed, Europe PMC, Embase, Web of Science, Scopus, CENTRAL, and meeting proceedings for comparative studies of grade 3 or higher hepatotoxicity after KRAS G12C inhibitors. Matched risk ratios (RRs) and unadjusted cohort data were synthesized separately, the latter with an exact conditional odds ratio (OR).
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