Mechahougui Hiba, Gutmans James, Gouasmi Roumaïssa, Smekens Laure, Friedlaender Alex
Oncology Department, Geneva University Hospital (HUG), 1205 Geneva, Switzerland.
Cancer Research Center of Lyon, CNRS UMR5286, Inserm U1052, University of Lyon, 69100 Lyon, France.
Int J Mol Sci. 2025 Apr 16;26(8):3757. doi: 10.3390/ijms26083757.
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.
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。
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