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Published on: April 11, 2025
Targeting Oncogenic BRAF: Past, Present, and Future
Aubhishek Zaman1,2, Wei Wu1,2, Trever G Bivona3,4
1Department of Medicine, University of California, San Francisco, CA 94143, USA.
Abstract:
Identifying recurrent somatic genetic alterations of, and dependency on, the kinase BRAF has enabled a "precision medicine" paradigm to diagnose and treat BRAF-driven tumors. Although targeted kinase inhibitors against BRAF are effective in a subset of mutant BRAF tumors, resistance to the therapy inevitably emerges. In this review, we discuss BRAF biology, both in wild-type and mutant settings. We discuss the predominant BRAF mutations and we outline therapeutic strategies to block mutant BRAF and cancer growth. We highlight common mechanistic themes that underpin different classes of resistance mechanisms against BRAF-targeted therapies and discuss tumor heterogeneity and co-occurring molecular alterations as a potential source of therapy resistance. We outline promising therapy approaches to overcome these barriers to the long-term control of BRAF-driven tumors and emphasize how an extensive understanding of these themes can offer more pre-emptive, improved therapeutic strategies.
Insights
Targeted BRAF kinase inhibitors treat BRAF-driven cancers, but resistance develops. This review explores BRAF mutations, resistance mechanisms, and strategies to overcome them for improved cancer therapy.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- BRAF alterations drive specific cancers, leading to precision medicine approaches.
- Targeted BRAF inhibitors are effective but face inevitable therapeutic resistance.
Purpose of the Study:
- To review BRAF biology in both normal and mutated states.
- To outline current and emerging therapeutic strategies for BRAF-driven tumors.
- To discuss mechanisms of resistance to BRAF-targeted therapies.
Main Methods:
- Literature review of BRAF biology and targeted therapies.
- Analysis of resistance mechanisms in BRAF-mutant cancers.
- Exploration of novel therapeutic strategies.
Main Results:
- Predominant BRAF mutations and their role in cancer identified.
- Common resistance mechanisms, including tumor heterogeneity, are highlighted.
- Promising therapeutic approaches to overcome resistance are discussed.
Conclusions:
- Understanding BRAF biology and resistance is crucial for effective cancer treatment.
- Developing strategies to overcome resistance can improve long-term control of BRAF-driven tumors.
- Integrated knowledge can lead to more preemptive and effective therapeutic interventions.
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