Expanding the Reach of Precision Oncology by Drugging All KRAS Mutants
Marco H Hofmann1, Daniel Gerlach1, Sandra Misale2
1Discovery Research, Boehringer Ingelheim RCV GmbH & Co KG, Vienna, Austria.
Abstract:
KRAS is the most frequently mutated oncogene, harboring mutations in approximately one in seven cancers. Allele-specific KRASG12C inhibitors are currently changing the treatment paradigm for patients with KRASG12C-mutated non-small cell lung cancer and colorectal cancer. The success of addressing a previously elusive KRAS allele has fueled drug discovery efforts for all KRAS mutants. Pan-KRAS drugs have the potential to address broad patient populations, including KRASG12D-, KRASG12V-, KRASG13D-, KRASG12R-, and KRASG12A-mutant or KRAS wild-type-amplified cancers, as well as cancers with acquired resistance to KRASG12C inhibitors. Here, we review actively pursued allele-specific and pan-KRAS inhibition strategies and their potential utility.
Significance:
Mutant-selective KRASG12C inhibitors target a fraction (approximately 13.6%) of all KRAS-driven cancers. A broad arsenal of KRAS drugs is needed to comprehensively conquer KRAS-driven cancers. Conceptually, we foresee two future classes of KRAS medicines: mutant-selective KRAS drugs targeting individual variant alleles and pan-KRAS therapeutics targeting a broad range of KRAS alterations.
Insights
Targeting KRAS mutations in cancer is advancing rapidly. New allele-specific and pan-KRAS inhibitors offer hope for broader patient populations beyond KRASG12C-mutated cancers.
Area of Science:
- Oncology
- Molecular Biology
- Drug Discovery
Background:
- KRAS is the most frequently mutated oncogene, found in about 14% of all cancers.
- KRASG12C inhibitors have transformed treatment for specific non-small cell lung and colorectal cancers.
- Targeting KRAS mutations is crucial for developing new cancer therapies.
Purpose of the Study:
- To review current allele-specific and pan-KRAS inhibition strategies.
- To discuss the potential utility of these novel therapeutic approaches.
- To highlight the need for a broader arsenal of KRAS-targeting drugs.
Main Methods:
- Review of actively pursued allele-specific KRAS inhibition strategies.
- Review of actively pursued pan-KRAS inhibition strategies.
- Analysis of potential patient populations for these therapies.
Main Results:
- Mutant-selective KRASG12C inhibitors currently target a subset of KRAS-driven cancers.
- Pan-KRAS drugs show potential for treating various KRAS alterations, including KRASG12D, KRASG12V, and resistance to KRASG12C inhibitors.
- Future KRAS medicines are expected to include both mutant-selective and pan-KRAS therapeutics.
Conclusions:
- Developing a comprehensive set of KRAS drugs is essential for effectively treating KRAS-driven cancers.
- Both allele-specific and pan-KRAS strategies are vital for addressing diverse KRAS alterations.
- These advancements promise to expand treatment options for a wider range of cancer patients.
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