you will meet the study staff, give informed consent, and undergo baseline assessments such as blood tests, imaging, and a review of your medical history.

the purpose of these assessments is to document your condition before any study medication is started.

you will begin taking adagrasib, a film‑coated tablet taken by mouth, at a dose of 9999 mg per day. the exact schedule (for example, once daily) will be provided by the study team.

the tablet is intended to be swallowed with water and should be taken at the same time each day.

in addition to adagrasib, you will receive dexamethasone, an oral steroid, at a dose of 9999 mg. this medication helps reduce inflammation and may lessen certain side effects.

if your treatment plan includes additional cancer medicines, you will receive them by intravenous (iv) infusion, which means the drug is given through a needle into a vein.

the iv medicines may include pemetrexed (dose 9999 mg/ml), cetuximab (dose 9999 mg/m2), and pembrolizumab (dose 9999 mg/ml). each will be given on the days scheduled by the study team.

to help prevent nausea, you will also receive palonosetron by iv at a dose of 9999 µg/ml.

you will return to the clinic regularly (for example, every 4 weeks) for physical examinations, blood tests, and to discuss any side effects you have experienced.

the study staff will record any adverse events, which are any unwanted medical occurrences, whether or not they are related to the study medication.

you will continue taking the oral medication and receiving any iv medications as long as you remain in the study, up to the planned end date of february 28, 2028, unless a serious side effect requires stopping the treatment.

at the end of the study, you will have a final assessment that includes a physical exam, laboratory tests, and a summary of any side effects that occurred during the study.

the results of these assessments will be used to evaluate the long‑term safety of adagrasib alone or in combination with the other cancer therapies.