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RAS 靶向癌症治疗的现状和未来趋势。

The current state of the art and future trends in RAS-targeted cancer therapies.

机构信息

Division of Hematology and Medical Oncology, Department of Medicine, Laura and Isaac Perlmutter Cancer Center, New York University (NYU) Grossman School of Medicine, NYU Langone Health, New York, NY, USA.

出版信息

Nat Rev Clin Oncol. 2022 Oct;19(10):637-655. doi: 10.1038/s41571-022-00671-9. Epub 2022 Aug 26.


DOI:10.1038/s41571-022-00671-9
PMID:36028717
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9412785/
Abstract

Despite being the most frequently altered oncogenic protein in solid tumours, KRAS has historically been considered 'undruggable' owing to a lack of pharmacologically targetable pockets within the mutant isoforms. However, improvements in drug design have culminated in the development of inhibitors that are selective for mutant KRAS in its active or inactive state. Some of these inhibitors have proven efficacy in patients with KRAS-mutant cancers and have become practice changing. The excitement associated with these advances has been tempered by drug resistance, which limits the depth and/or duration of responses to these agents. Improvements in our understanding of RAS signalling in cancer cells and in the tumour microenvironment suggest the potential for several novel combination therapies, which are now being explored in clinical trials. Herein, we provide an overview of the RAS pathway and review the development and current status of therapeutic strategies for targeting oncogenic RAS, as well as their potential to improve outcomes in patients with RAS-mutant malignancies. We then discuss challenges presented by resistance mechanisms and strategies by which they could potentially be overcome.

摘要

尽管 KRAS 是实体瘤中最常被改变的致癌蛋白,但由于突变体亚型中缺乏药理学上可靶向的口袋,它在历史上一直被认为是“不可成药的”。然而,药物设计的改进最终导致了针对突变型 KRAS 处于活性或非活性状态的抑制剂的开发。其中一些抑制剂已被证明在 KRAS 突变型癌症患者中具有疗效,并改变了临床实践。这些进展带来的兴奋情绪因耐药性而受到抑制,耐药性限制了这些药物的反应深度和/或持续时间。对癌细胞中 RAS 信号转导和肿瘤微环境的理解的提高表明,几种新的联合治疗方法具有潜力,目前正在临床试验中进行探索。在此,我们概述了 RAS 通路,并回顾了针对致癌性 RAS 的治疗策略的开发和现状,以及它们改善 RAS 突变恶性肿瘤患者结局的潜力。然后,我们讨论了耐药机制带来的挑战以及克服这些挑战的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2352/9412785/efab54796137/41571_2022_671_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2352/9412785/f678674497cd/41571_2022_671_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2352/9412785/452ac1fa4611/41571_2022_671_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2352/9412785/efab54796137/41571_2022_671_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2352/9412785/f678674497cd/41571_2022_671_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2352/9412785/452ac1fa4611/41571_2022_671_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2352/9412785/efab54796137/41571_2022_671_Fig3_HTML.jpg

相似文献

[1]
The current state of the art and future trends in RAS-targeted cancer therapies.

Nat Rev Clin Oncol. 2022-10

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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Int Rev Cell Mol Biol. 2024

[9]
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Cancer Treat Rev. 2020-7-15

[10]
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Mol Cancer. 2022-8-4

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[5]
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[6]
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[10]
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本文引用的文献

[1]
Acquired Genomic Alterations on First-Line Chemotherapy With Cetuximab in Advanced Colorectal Cancer: Circulating Tumor DNA Analysis of the CALGB/SWOG-80405 Trial (Alliance).

J Clin Oncol. 2023-1-20

[2]
Adagrasib in Non-Small-Cell Lung Cancer Harboring a Mutation.

N Engl J Med. 2022-7-14

[3]
A saturation mutagenesis screen uncovers resistant and sensitizing secondary mutations to clinical KRAS inhibitors.

Proc Natl Acad Sci U S A. 2022-5-3

[4]
KRAS is vulnerable to reversible switch-II pocket engagement in cells.

Nat Chem Biol. 2022-6

[5]
Proteolytic pan-RAS Cleavage Leads to Tumor Regression in Patient-derived Pancreatic Cancer Xenografts.

Mol Cancer Ther. 2022-5-4

[6]
Protection against SARS-CoV-2 after Covid-19 Vaccination and Previous Infection.

N Engl J Med. 2022-3-31

[7]
Rapid idiosyncratic mechanisms of clinical resistance to KRAS G12C inhibition.

J Clin Invest. 2022-2-15

[8]
Sotorasib for previously treated colorectal cancers with KRAS mutation (CodeBreaK100): a prespecified analysis of a single-arm, phase 2 trial.

Lancet Oncol. 2022-1

[9]
Identification of MRTX1133, a Noncovalent, Potent, and Selective KRAS Inhibitor.

J Med Chem. 2022-2-24

[10]
Diverse alterations associated with resistance to KRAS(G12C) inhibition.

Nature. 2021-11

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