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KRAS:结肠癌患者的一个可用药靶标。

KRAS: A Druggable Target in Colon Cancer Patients.

机构信息

Gastroenterology and Endoscopy Unit, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy.

Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

出版信息

Int J Mol Sci. 2022 Apr 8;23(8):4120. doi: 10.3390/ijms23084120.

Abstract

Mutations in are among the most frequent aberrations in cancer, including colon cancer. KRAS direct targeting is daunting due to KRAS protein resistance to small molecule inhibition. Moreover, its elevated affinity to cellular guanosine triphosphate (GTP) has made the design of specific drugs challenging. Indeed, KRAS was considered 'undruggable'. KRASG12C is the most commonly mutated variant of KRAS in non-small cell lung cancer. Currently, the achievements obtained with covalent inhibitors of this variant have given the possibility to assess the best therapeutic approach to KRAS-driven tumors. Mutation-related biochemical assets and the tissue of origin are expected to influence responses to treatment. Further attempts to obtain mutant-specific KRAS (KRASG12C) switch-II covalent inhibitors are ongoing and the results are promising. Drugs targeted to block KRAS effector pathways could be combined with direct KRAS inhibitors, immunotherapy or T cell-targeting approaches in KRAS-mutant tumors. The development of valuable combination regimens will be essential against potential mechanisms of resistance that may arise during treatment.

摘要

是癌症中最常见的异常之一,包括结肠癌。由于 KRAS 蛋白对小分子抑制的抵抗力,直接靶向 KRAS 具有挑战性。此外,其与细胞鸟嘌呤三磷酸 (GTP) 的亲和力升高使得设计特异性药物具有挑战性。事实上,KRAS 被认为是“不可成药的”。KRASG12C 是非小细胞肺癌中 KRAS 最常见的突变变体。目前,用这种变体的共价抑制剂取得的成就使人们有可能评估针对 KRAS 驱动的肿瘤的最佳治疗方法。突变相关的生化资产和起源组织预计会影响对治疗的反应。目前正在进行获得突变特异性 KRAS(KRASG12C)开关-II 共价抑制剂的进一步尝试,结果令人鼓舞。针对 KRAS 效应子途径的药物可以与直接 KRAS 抑制剂、免疫疗法或 T 细胞靶向方法联合用于 KRAS 突变肿瘤。针对可能在治疗过程中出现的潜在耐药机制,开发有价值的联合方案至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c096/9027058/1168e9eee92c/ijms-23-04120-g001.jpg

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