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Published on: October 5, 2020
Distinct ERK and PI3K dependencies mediate a heterogeneous response to RAS(ON) inhibition in KRAS-mutant colorectal
Philip H Choi1, Julia Meredith2, Malvika Sharma2
1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Abstract:
RAS inhibitors have demonstrated limited efficacy in KRAS-mutant colorectal cancer (CRC). Here, we evaluate RMC-7977, a RAS(ON) multi-selective inhibitor, which shows a heterogeneous response in a panel of preclinical CRC models. Inhibition of PI3K signaling and cyclin D1 (CCND1) expression are strongly correlated with response. We find that stratifying tumors based on the ERK dependence of cyclin D1, mediated by variability in CCND1 mRNA regulation, reveals two distinct resistance mechanisms. PI3K signaling plays a key role in driving persistent cyclin D1 expression in the less ERK-dependent tumors, and concurrent inhibition of RAS and PI3K can synergistically cause cell cycle arrest and promote apoptosis. However, in tumors with strongly ERK-dependent cyclin D1, vertical inhibition of RAS and MEK prevents feedback re-activation of the MAPK/ERK pathway and is more effective. In summary, we identify cyclin D1 as an important integrator and functional readout of upstream signaling that can inform optimal combination strategies for KRAS-mutant CRC.
Insights
RAS inhibitors show limited efficacy in KRAS-mutant colorectal cancer (CRC). New research identifies cyclin D1 as a key factor, suggesting combination therapies targeting RAS and PI3K or MEK for improved CRC treatment.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- RAS inhibitors have shown limited success in KRAS-mutant colorectal cancer (CRC).
- Understanding resistance mechanisms is crucial for developing effective treatments.
- Cyclin D1 (CCND1) regulation is implicated in cancer cell proliferation.
Purpose of the Study:
- To evaluate the efficacy of RMC-7977, a novel RAS(ON) multi-selective inhibitor, in preclinical CRC models.
- To identify biomarkers and resistance mechanisms associated with RAS inhibitor response.
- To inform optimal combination strategies for KRAS-mutant CRC.
Main Methods:
- Preclinical testing of RMC-7977 in a panel of colorectal cancer models.
- Analysis of PI3K signaling inhibition and cyclin D1 (CCND1) expression.
- Stratification of tumors based on ERK dependence of cyclin D1 and CCND1 mRNA regulation.
- Evaluation of combination therapies including RAS, PI3K, and MEK inhibitors.
Main Results:
- RMC-7977 demonstrated heterogeneous responses in CRC models.
- PI3K signaling inhibition and CCND1 expression levels correlated strongly with treatment response.
- Two distinct resistance mechanisms were identified based on ERK dependence of CCND1.
- Concurrent RAS and PI3K inhibition showed synergistic effects in less ERK-dependent tumors.
- Vertical RAS and MEK inhibition was more effective in strongly ERK-dependent tumors.
Conclusions:
- Cyclin D1 (CCND1) serves as a critical integrator of upstream signaling in KRAS-mutant CRC.
- Stratifying tumors by ERK dependence of CCND1 can guide combination therapy selection.
- Targeting PI3K or MEK alongside RAS inhibitors offers potential for improved efficacy in CRC.
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