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Updated: Jan 14, 2026

A Method for Screening and Validation of Resistant Mutations Against Kinase Inhibitors
Published on: December 7, 2014
Resistance to the KRASG12D Inhibitor MRTX1133 Is Associated with Increased Sensitivity to BET Inhibition
Daniel R Principe1,2, Jeffrey H Becker2,3, Anastasia E Metropulos2,3
1Department of Medicine, Physician Scientist Training Program, University of Wisconsin, Madison, Wisconsin.
KRASG12D inhibitors show limited efficacy in pancreatic cancer. Combining these with BET inhibitors overcomes resistance by targeting FOSL1 signaling, offering a promising therapeutic strategy for KRAS-mutated pancreatic ductal adenocarcinoma.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Genetics
Background:
- Pancreatic ductal adenocarcinoma (PDAC) frequently harbors KRAS mutations.
- KRASG12D inhibitors demonstrate limited efficacy as monotherapy, necessitating resistance mechanisms research.
Purpose of the Study:
- To investigate mechanisms of resistance to KRASG12D inhibitors in PDAC.
- To identify potential therapeutic strategies to overcome KRAS inhibitor resistance.
Main Methods:
- Generated in vitro models of resistance to MRTX1133, a KRASG12D inhibitor.
- Utilized RNA sequencing to compare resistant and parental cell lines.
- Investigated the role of EP300, FOSL1, and BET proteins in resistance.
- Tested combination therapies in vitro and in murine models of PDAC.
Main Results:
- MRTX1133-resistant cells exhibited increased histone acetylation and upregulated FOSL1 signaling.
- Inhibition of EP300 or FOSL1 reversed the resistant phenotype in vitro.
- BET inhibitors re-sensitized resistant cell lines to MRTX1133 and suppressed FOSL1 signaling.
- Combination of MRTX1133 and BET inhibitors significantly improved survival in preclinical models.
Conclusions:
- Acquired resistance to KRAS inhibition in PDAC involves epigenetic alterations and FOSL1 pathway activation.
- Targeting BET proteins in combination with KRASG12D inhibitors represents a viable strategy to overcome resistance.
- This combination therapy warrants further clinical investigation for KRAS-mutated PDAC.
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