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KRASG12C inhibition produces a driver-limited state revealing collateral dependencies
Kevin Lou1, Veronica Steri2,3, Alex Y Ge2,4
1Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA 94158, USA.
Abstract:
Inhibitors targeting KRASG12C, a mutant form of the guanosine triphosphatase (GTPase) KRAS, are a promising new class of oncogene-specific therapeutics for the treatment of tumors driven by the mutant protein. These inhibitors react with the mutant cysteine residue by binding covalently to the switch-II pocket (S-IIP) that is present only in the inactive guanosine diphosphate (GDP)-bound form of KRASG12C, sparing the wild-type protein. We used a genome-scale CRISPR interference (CRISPRi) functional genomics platform to systematically identify genetic interactions with a KRASG12C inhibitor in cellular models of KRASG12C mutant lung and pancreatic cancer. Our data revealed genes that were selectively essential in this oncogenic driver-limited cell state, meaning that their loss enhanced cellular susceptibility to direct KRASG12C inhibition. We termed such genes "collateral dependencies" (CDs) and identified two classes of combination therapies targeting these CDs that increased KRASG12C target engagement or blocked residual survival pathways in cells and in vivo. From our findings, we propose a framework for assessing genetic dependencies induced by oncogene inhibition.
Insights
Targeting KRAS G12C with new inhibitors shows promise for cancer treatment. Researchers identified "collateral dependencies" to enhance therapy effectiveness and block cancer cell survival.
Area of Science:
- Oncology
- Genomics
- Pharmacology
Background:
- KRAS G12C is a common oncogenic driver in various cancers.
- KRAS G12C inhibitors offer a targeted therapeutic approach by binding to the mutant cysteine residue.
- Understanding resistance mechanisms and dependencies is crucial for optimizing KRAS G12C inhibitor efficacy.
Purpose of the Study:
- To systematically identify genetic interactions with KRAS G12C inhibitors using a CRISPR interference platform.
- To discover genes that, when lost, sensitize cells to KRAS G12C inhibition, termed "collateral dependencies" (CDs).
- To explore combination therapies targeting these CDs for enhanced anti-cancer effects.
Main Methods:
- Utilized a genome-scale CRISPR interference (CRISPRi) functional genomics platform.
- Screened cellular models of KRAS G12C-mutant lung and pancreatic cancer.
- Identified genes essential in the KRAS G12C-inhibitor-treated state.
Main Results:
- Discovered novel "collateral dependencies" (CDs) – genes whose loss enhances sensitivity to KRAS G12C inhibitors.
- Identified two classes of combination therapies targeting CDs.
- Demonstrated that targeting CDs can increase KRAS G12C target engagement and block residual survival pathways in vitro and in vivo.
Conclusions:
- KRAS G12C inhibitors represent a significant advancement in oncogene-specific cancer therapy.
- Collateral dependencies offer new targets for combination strategies to overcome treatment resistance.
- A framework for assessing genetic dependencies induced by oncogene inhibition was proposed.
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