Diaz Bianca J, Kops Max, Bernardo Sara, Schmidt Henri, Grankowsky Elizabeth, Vega Adrian, Zhang Chen, Bott Matthew, Skamagki Maria, Tomlinson Aidan, Vita Nicole A, Katti Alyna, Labrecque Mark P, Aronchik Ida, Singh Mallika, Dow Lukas E
Sandra and Edward Meyer Cancer Center, Department of Medicine, Weill Cornell Medicine, New York, NY.
Weill Cornell Graduate School of Medical Sciences, Weill Cornell Medicine, New York, NY.
bioRxiv. 2025 Aug 4:2025.08.04.668444. doi: 10.1101/2025.08.04.668444.
mutations are among the most prevalent oncogenic drivers in non-small cell lung cancer (NSCLC), yet the mechanisms of therapeutic resistance to KRAS inhibitors in these cancers remains poorly understood. Here, we deploy high-throughput CRISPR base editing screens to systematically map resistance mutations to three mechanistically distinct KRAS-targeted therapies, including KRAS-G12C(OFF) inhibitor (adagrasib), RAS(ON) G12C-selective tri-complex inhibitor (RMC-4998), and RAS(ON) multi-selective tri-complex inhibitor (RMC-7977). Using both a saturation tiling approach and cancer-associated mutation library, we identify common and compound-selective second-site resistance mutations in , as well as gain-of-function and loss-of-function variants across cancer-associated genes that rewire signaling networks in a context-dependent manner. Notably, we identify a recurrent missense mutation in capicua (), that promotes resistance to RMC-7977 in vitro and in vivo. Moreover, we show that targeting NFκB signaling in CIC-mutant cells can resensitize them to RAS pathway inhibition and overcome resistance.
突变是非小细胞肺癌(NSCLC)中最常见的致癌驱动因素之一,但这些癌症对KRAS抑制剂产生治疗抗性的机制仍知之甚少。在此,我们采用高通量CRISPR碱基编辑筛选方法,系统地绘制针对三种机制不同的KRAS靶向疗法的抗性突变图谱,这三种疗法包括KRAS-G12C(OFF)抑制剂(阿达格拉西布)、RAS(ON)G12C选择性三复合物抑制剂(RMC-4998)和RAS(ON)多选择性三复合物抑制剂(RMC-7977)。利用饱和平铺方法和癌症相关突变文库,我们在[未提及的具体基因]中鉴定出常见的和化合物选择性的第二位点抗性突变,以及癌症相关基因中功能获得性和功能丧失性变体,这些变体以上下文依赖的方式重塑信号网络。值得注意的是,我们在capicua(CIC)中鉴定出一个复发性错义突变,该突变在体外和体内均促进对RMC-7977的抗性。此外,我们表明,在CIC突变细胞中靶向NFκB信号传导可使它们对RAS途径抑制重新敏感并克服抗性。