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实体瘤中的BRAF靶向治疗:分子层面与临床应用

BRAF Targeting Across Solid Tumors: Molecular Aspects and Clinical Applications.

作者信息

Mechahougui Hiba, Gutmans James, Gouasmi Roumaïssa, Smekens Laure, Friedlaender Alex

机构信息

Oncology Department, Geneva University Hospital (HUG), 1205 Geneva, Switzerland.

Cancer Research Center of Lyon, CNRS UMR5286, Inserm U1052, University of Lyon, 69100 Lyon, France.

出版信息

Int J Mol Sci. 2025 Apr 16;26(8):3757. doi: 10.3390/ijms26083757.


DOI:10.3390/ijms26083757
PMID:40332392
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12027668/
Abstract

BRAF mutations are critical drivers in cancers such as melanoma, colorectal cancer, and non-small-cell lung cancer. The most common mutation, , is a key therapeutic target. Targeted treatments with BRAF and MEK inhibitors have significantly improved progression-free and overall survival in melanoma patients. However, in cancers like metastatic colorectal cancer, BRAF mutations are associated with poor outcomes due to aggressive disease behavior and resistance to conventional chemotherapy. Despite progress, resistance to BRAF/MEK inhibitors remains a major challenge, often driven by secondary mutations in the mitogen-activated protein kinase (MAPK) pathway, activation of alternative pathways such as phosphoinositide 3-kinases (PI3Ks)/protein kinase B (AKT), or changes in the tumor microenvironment. These challenges have motivated ongoing research into combining BRAF inhibitors with immunotherapies to enhance and prolong treatment effectiveness. Future research must also account for the role of the cancer's tissue of origin, as the biological context significantly influences response to targeted therapies, highlighting the need for a deeper understanding of tumor biology, micro-environment, and genetics.

摘要

BRAF突变是黑色素瘤、结直肠癌和非小细胞肺癌等癌症的关键驱动因素。最常见的突变是一个关键的治疗靶点。使用BRAF和MEK抑制剂的靶向治疗显著改善了黑色素瘤患者的无进展生存期和总生存期。然而,在转移性结直肠癌等癌症中,由于疾病侵袭性和对传统化疗的耐药性,BRAF突变与不良预后相关。尽管取得了进展,但对BRAF/MEK抑制剂的耐药性仍然是一个主要挑战,这通常是由丝裂原活化蛋白激酶(MAPK)途径中的二次突变、磷酸肌醇3激酶(PI3K)/蛋白激酶B(AKT)等替代途径的激活或肿瘤微环境的变化所驱动的。这些挑战推动了将BRAF抑制剂与免疫疗法联合使用以增强和延长治疗效果的持续研究。未来的研究还必须考虑癌症起源组织的作用,因为生物学背景会显著影响对靶向治疗的反应,这凸显了深入了解肿瘤生物学、微环境和遗传学的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b1/12027668/058dfecbcd7f/ijms-26-03757-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b1/12027668/5e5de94c7975/ijms-26-03757-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b1/12027668/058dfecbcd7f/ijms-26-03757-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b1/12027668/5e5de94c7975/ijms-26-03757-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94b1/12027668/058dfecbcd7f/ijms-26-03757-g002.jpg

相似文献

[1]
BRAF Targeting Across Solid Tumors: Molecular Aspects and Clinical Applications.

Int J Mol Sci. 2025-4-16

[2]
BRAF inhibitors in cancer therapy.

Pharmacol Ther. 2013-12-8

[3]
Molecular pathways: response and resistance to BRAF and MEK inhibitors in BRAF(V600E) tumors.

Clin Cancer Res. 2013-12-18

[4]
Clinical Development of BRAF plus MEK Inhibitor Combinations.

Trends Cancer. 2020-9

[5]
Clinical Acquired Resistance to RAF Inhibitor Combinations in BRAF-Mutant Colorectal Cancer through MAPK Pathway Alterations.

Cancer Discov. 2015-4

[6]
Targeting the multifaceted BRAF in cancer: New directions.

Oncotarget. 2024-7-16

[7]
Role of mitochondria and potential of mitochondria-targeted therapy in BRAF mutant cancer: A review.

Crit Rev Oncol Hematol. 2024-11

[8]
Defining and Targeting BRAF Mutations in Solid Tumors.

Curr Treat Options Oncol. 2021-2-27

[9]
Molecular pathways: adaptive kinome reprogramming in response to targeted inhibition of the BRAF-MEK-ERK pathway in cancer.

Clin Cancer Res. 2014-5-15

[10]
Targeting -Mutant Non-Small Cell Lung Cancer: From Molecular Profiling to Rationally Designed Therapy.

Oncologist. 2017-7

引用本文的文献

[1]
Coexistence of low-grade pulmonary mucinous epithelioid carcinoma and metastatic adrenal sarcomatoid carcinoma: a rare case report with BRAF p.V600E-driven molecular insights and clinical challenges.

Front Oncol. 2025-8-15

[2]
Advances in PD-1/PD-L1 pathway inhibitors in the treatment of thyroid cancer: mechanisms and clinical therapeutic perspectives.

Front Immunol. 2025-8-8

本文引用的文献

[1]
Regorafenib Combined with BRAF/MEK Inhibitors for the Treatment of Refractory Melanoma Brain Metastases.

Cancers (Basel). 2024-12-5

[2]
BRAF-Mutated Melanoma Cell Lines Develop Distinct Molecular Signatures After Prolonged Exposure to AZ628 or Dabrafenib: Potential Benefits of the Antiretroviral Treatments Cabotegravir or Doravirine on BRAF-Inhibitor-Resistant Cells.

Int J Mol Sci. 2024-11-6

[3]
Therapeutic vulnerabilities and pan-cancer landscape of BRAF class III mutations in epithelial solid tumors.

BJC Rep. 2024-10-8

[4]
EGF/EGFR-YAP1/TEAD2 signaling upregulates STIM1 in vemurafenib resistant melanoma cells.

FEBS J. 2024-11

[5]
The ERK5 pathway in BRAFV600E melanoma cells plays a role in development of acquired resistance to dabrafenib but not vemurafenib.

FEBS Lett. 2024-8

[6]
A large-scale, multicenter characterization of BRAF G469V/A-mutant non-small cell lung cancer.

Cancer Med. 2024-5

[7]
Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.

CA Cancer J Clin. 2024

[8]
BRAF - a tumour-agnostic drug target with lineage-specific dependencies.

Nat Rev Clin Oncol. 2024-3

[9]
Unraveling the nexus: oncogenic drivers and immunotherapy efficacy in cancer treatment.

Immunotherapy. 2024-3

[10]
Targeting the RAS/RAF/MAPK pathway for cancer therapy: from mechanism to clinical studies.

Signal Transduct Target Ther. 2023-12-18

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